Effects of Tourniquet in Total Knee Arthroplasty

Abstract

Tourniquet has long been used in TKA (Total Knee Arthroplasty) as the other orthopedic procedures for decreasing operation time and blood loss, providing better visualization of anatomic structures. While having much more advantages, these devices have a potential of serious complications, so they must be used with adequate knowledge and attention. Paralysis, compression neuropathy, compartment syndrome, prolonged period of rehabilitation, edema, pain, skin problems, nerve damage and systemic problems are the some complications seen. Selections of appropriate blood pressure, cuff selection, tourniquet timing are the essential points of tourniquet use. Through these increasing complication rates and improvements in the surgical and anesthesia methods contrary to old beliefs, surgery has been preferred without tourniquet in the patients who have no cardiovascular problems and morbidity. In the patients who have any contraindicated situations as stated above, TKA must be performed with tourniquet, with proper control of the amount of pressure and the duration of application, the risk of complications decrease, in the other situations TKA can be performed without tourniquet with the aims for fast-recovery, postsurgical pain relief and better muscle activity. The objective of this paper is to describe current perspectives of tourniquet use in total knee arthroplasty.