Comparison to effect and safety of using tourniquet during different time interval of total kneearthroplasty

Abstract

Objective To explore the effect and safety of using tourniquet to patients during differenttime interval of total knee arthroplasty. Methods A total of 80 cases of patients, who had total knee arthroplasty at our hospital from 2010 to 2012, were divided into the experimental group and the control group randomly, according to the computer random grouping method, 40 cases each. The patients in the experimental group were used the tourniquet method when the osteotomy began. The tourniquet was used to the control group during the whole operation process. Various intraoperative indexes were compared between groups ： hemoglobin content （ 1, 3 and 5 day postoperatively）, red blood cell count and postoperative complications. Results The operation time and lose of blood volume of patients in the experimental group were （136.7 ± 18.6） min and （167.8 ± 16.8 ） ml. The operation time and lose of blood volume of patients in the control group were （138.6 ± 19.4） min and （ 174.8 ± 14.6） ml. There were no significant differences between these two groups of patients （ t = 0. 447, 1. 989, respectively; P 〉 0.05 ）. The hemoglobin content of 1,3 and 5 days postoperatively of the experimental group were （7.6 ± 0.8 ）, （ 15.9 ± 1. 1 ） and （ 16.3 ~ 1.3 ） g/L, respectively. The hemoglobin content of 1, 3 and 5 days postoperatively of the control group were （7.9 ± 0.7 ）, （ 16.4 ± 1.2 ） and （ 16.8 ± 1.1 ） g/L, respectively. The comparison between groups were without statistical differences （ t = 1. 785, 1. 943, 1. 857, respectively; P 〉 0.05 ）. The red blood cell count of 1, 3 and 5 days postoperatively of the experimental group were （0. 18 20.02）, （1.23 20.22） and （1.58 ±0.39） ×1012/L, respectively. The red blood cell count of 1, 3 and 5 days postoperatively of the control group were （0. 19 ~ 0.03）, （ 1.34 ±0.28 ） and （ 1.74 ± 0.42） × 1012/L, respectively. The comparison between groups were without statistical differences （t = 1. 754, 1. 954, 1. 766, respectively; P 〉0.05）. The incidence of postoperative complication in the control group was 52.5%, among which 6 cases suffered deep vein thrombosis, 4 cases suffered phase II wound infection, 7 cases suffered knee joint cavity heamatoma and 4 cases suffered common peroneal nerve injury. The incidence of postoperative complication in the experimental group was 5.0% , among which 1 cases suffered deep vein thrombosis, and 1 ease suffered heamatoma of knee joint cavity. There was no significant difference （ X2 = 22. 029, P 〈 0.05 ）. Conclusions Application the tourniquet method to patients during different time interval of total knee arthroplasty can reduce patients＇ postoperative complications, and it makes great contribution to patients＇ postoperative recovery. Key words: j- Knee; Arthroplasty; Replacement; Tourniquet; Time interval