Effect of tourniquet use on total blood loss following total knee arthroplasty

Abstract

Objectives: Blood loss during total knee arthroplasty (TKA) can be a concern. Therefore, a tourniquet (TQ) is commonly used during the procedure to minimize this risk. However, the use of a TQ in TKA continues to be a matter of debate among orthopedic surgeons and is related to its advantages and disadvantages. We retrospectively evaluated the impact of applying the TQ on total blood loss following TKA in 276 patients. Methods: Patients were categorized into two groups: TQ and non- TQ. Demographics, surgical time, pre- and post-operative hemoglobin levels, number of blood units transfused, and rate of venous thromboembolism (VTE) were compared between the groups. The mean age of the study population was 62.8 ± 7.2 years, and 76.4% of patients were females. The TQ group consisted of 159 patients, whereas the non-TQ group consisted of 117 patients. Results: The two groups were homogenous, and there was no statistically significant difference in age or gender distribution between the two groups. The results showed no significant difference in total blood loss, need for blood transfusion, or VTE rate postoperatively when using a TQ. Female gender was identified to be a significant predictor of a decrease in post-operative hemoglobin. Conclusion: We found that the use of the TQ had no effect on total blood loss following primary TKA. Female gender was a predictor of increased blood loss in both groups. It is essential that surgeons performing arthroplasty balance the risks and benefits of using a TQ during TKA.