Effect of tourniquet on deep venous thrombosis after total knee arthroplasty

Abstract

Objective To determine the effect of tourniquet on deep venous thrombosis after total knee arthroplasty. Methods Eighty patients were prospectively randomized into 2 groups: Group A (40 pa-tients) underwent the operation with a tourniquet, and Group B (40 patients) underwent the operation without a tourniquet. Blood loss, the rate of deep vein thrombosis (DVT) and pulmonary embolism (PE), and the area of embolus (%Ae, total embolus area/total right atrium area) was evaluated. DVT was detected using Doppler ultrasound preoperatively and 1-10 days after the operation, and the area of embolus was evaluated by transesophageal echocardiography (TEE) during the operation. Results There was no significant difference in total blood loss between the two groups although the intraoperative blood loss in the group A was signifi-cant less than those of in the group B. There was no significant difference in the incidence of postoperative DVT between the two groups. No PE was detected in the two groups. The area of embolus in group A rose to peak in 1 minute after the release of tourniquet, while it rose to peak when the procedure of reaming and prosthesis implanting was performed, and then decrease slowly in group B. But the area of embolus was al-ways higher in group A after release of tourniquet compared with that of group B. Conclusion Using tourniquet has no significant effect on perioperative total blood loss during total knee arthroplasty, and can not increase the risk of DVT and PE after total knee arthroplasty. Key words: Arthroplasty; replacement; knee; Tourniquets; Venous thrombosis