CORR Insights(®): Does Tourniquet Use in TKA Affect Recovery of Lower Extremity Strength and Function? A Randomized Trial.

Abstract

T ourniquet use during TKA [1] offers better visibility, decreases intraoperative bleeding, and helps in cement-bone interdigitation during surgery [4, 10]. Despite these benefits, the development of thromboembolic events like deep venous thrombosis [2, 13], pulmonary embolism [5], or multiple cerebral and cardiac microemboli [8, 9] all remain a concern when considering tourniquet use. Other complications include increased leg swelling and pain after release [11, 12], tourniquet-induced wound problems [7], peripheral nerve injury [6], or decreased knee ROM [3]. Although there are ongoing debates regarding the pros and cons of tourniquet use, no sufficient investigations have beenmade on its possible negative effect on the recovery of lower extremity strength and function, which are vital to postsurgical recovery. The current study by Dennis and colleagues adds to our understanding by finding greater postoperative quadriceps strength and lesser pain for patients in the nontourniquet cohort. In contrast, researchers found no differences in hamstring strength, quadriceps voluntary activation, or unilateral balance ability in patients who underwent bilateral simultaneous TKA. Additionally, the study results found more intraoperative blood loss in the nontourniquet group, but no differences in total blood loss or operative time when compared to the group undergoing same-day bilateral TKA.