Effects Of Different Ways Of Using Tourniquet During Total Knee Arthroplasty On Enhanced Recovery After Surgery

Objective: The purpose of this study was to explore how three strategies of lower limb pneumatic tourniquet application affect the outcome for TKA patients,Methods:In the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,a total of 90 patients who undergo TKA were randomized into one of the three groups: Group A-The tourniquet was inflated before incision and deflated after the ultimate suture and bandaging for 30 patients,Group B-it was inflated just before incision and deflated after the hardening of the cement for 30 patients,Group C-it was inflated just before cement application and deflated after its hardening for another 30 patients.Record and compare the operation time,tourniquet time,intraoperative bleeding,postope rative bleeding,total bleeding,invisible bleeding,VAS score and range of motion(ROM),HSS score)and postoperative wound complications,blood transfusi on rates,etc.Results: The group A had the least intraoperative blood loss(167.27 ± 7.60 ml),but the most postoperative drainage and hidden blood loss(30.47 ± 7.319 ml,454.70 ± 32.32 ml),the VAS score was relatively high in the early postoperative period with the worst range of motion;The group B performed the least total blood loss(591.80 ± 31.40 ml);The group C had the most intra operative blood loss(267.17 ± 29.22 ml),but there was no statistical difference on total blood loss with group A.Range of motion in group C was signific antly increased at 1 and 3 days after the surgery,but there was no difference at 1 month after operation compared with other two groups.In addition,there was no statistical difference in the performance of the three groups on other indi cators such as operation time and HSS score.Conclusion: With tourniquet used fully throughout the procedure,there is less bleeding during the operation but more postoperative hidden bleeding,and early postoperative pain,poor range of motion,and some wound complications.In the group of limited tourniquet usage,although with a large amount of intraoperative bleeding,there was less hidden blood loss after surgery and the total blood loss was similar to the group of tourniquet fully usage.The group of the tourniquet first-half usage had the lowest total bleeding and performed well in terms of pain and mobility in the early stages after surgery.Therefore,we recommend the use of tourniquets during the first half of total knee arthroplasty.