THE EFFECT OF A TOURNIQUET ON INTRAOPERATIVE SOFT TISSUE BALANCE IN CAS TOTAL KNEE ARTHROPLASTY

Abstract

Background: The acquirement of appropriate soft tissue balancing and accurate alignment is an essential procedure in total knee arthroplasty (TKA). Gap balancing affects the final knee kinematics , and inadequate correction of soft tissue imbalances is considered an important factor for early TKA failure. During total knee arthroplasty (TKA), tourniquets are widely used to provide clear visualization of the tissue. The aim of the present study was to evaluate the effect of a tourniquet on intraoperative soft tissue balance in CAS total knee arthroplasty. Method: In this prospective cohort study , patients were eligible for inclusion when they were scheduled for primary CAS TKA due to osteoarthritis , age between 50 and 75 years. Exclusion criteria were severe cardiac complaints , severe pulmonary disorders, Body Mass Index(BMD) > 35,severe coagulation disorder. Thirty knees operated by TKA using a navigation-assisted system (KICK system, DuPuy) were evaluated the soft tissue tension and compared between the tourniquet released and the tourniquet inflated in full extension (0°) and at 90° knee flexion. Result: In total, 30 consecutive patients undergoing CAS TKA met the inclusion criteria. There were differences but not statistically significant in terms of soft tissue tension in knee full extension medial side (p=0.616) , knee, full extension lateral side(p=0.780) , 90° knee flexion medial side (p=0.573) and 90° knee flexion lateral side (p=0.163) Conclusion: Our preliminary results showed that tourniquet application during CAS TKA did not significantly affect the soft tissue balance.