Controlled study of tourniquet in total knee arthroplasty of patients with high coagulation condition

Abstract

Objective To prospectively evaluate the postoperative hemostatic effect of using tourniquet with different way during total knee arthroplasty(TKA) in patients with high coagulation condition. Methods In the prospective study, 92 cases of patients received TKA with different tourniquet applications were enrolled (D-Dimer>1 000 μg/L) and randomly divided into group A (half-course group, n=46) using tourniquet only during cementation and group B (whole-course group, n=46) using tourniquet from incision to wound closure. The operation duration, wound drainage, hidden blood loss, total blood loss, hemoglobin loss, blood transfusion rate, average transfusion volume, pain score, range of motion, limb-swelling and complication were recorded and analyzed by t test and χ2 test using SPSS 19.0. Results The wound drainage, hidden blood loss, total blood loss, hemoglobin loss, pain score, limb-swelling and complications in group A were significantly lower than those in group B(t=-7.432, -15.72, -2.205, -2.746, -3.070, -5.525, all P 0.05). Conclusion Using half-course tourniquet has a better hemostatic effect and a lower complication suffering rate than using whole-course tourniquet after TKA in the patients with high coagulation condition. Key words: Arthroplasty, replacement, knee; Tourniquets; Blood coagulation