Clinical Analysis Of Different Tourniquet In Total Knee Arthroplasty

Background: Perioperative blood loss is a major problem in Total Knee Arthroplasty(TKA).The use of tourniquets can effectively reduce intraoperative bleeding,but whether patients can benefit from the use of tourniquets still needs further research and proof.Objective: To explore the effect of different tourniquet application schemes(using tourniquet throughout the operation or using tourniquet only during prosthesis installation)on perioperative recovery of patients with total knee arthroplasty(TKA).Methods: 80 patients who received unilateral TKA treatment for the first time were selected from the patients admitted to our hospital within two years from January 2019 to December 2020.They were randomly divided into whole treatment group and half treatment group,with 40 patients in each group.Among them,the group using tourniquet from opening to closing of the incision was the whole process group,and the group using tourniquet only during the prosthesis installation was the half process group.The operative time,perioperative blood loss(intraoperative blood loss,postoperative blood loss,and latent blood loss),postoperative complications,visual analog pain score(VAS),knee score(KSS),D-dimer and C-reactive protein(CRP)values before and after surgery were recorded and measured between the two groups.Results: Compared with the whole group,the operation time of the half group was longer(P <0.05),and the total blood loss was not significantly different,while the dominant blood loss was significantly increased and the recessive blood loss was significantly decreased(P < 0.05).On the other hand,postoperative pain score,lower limb swelling rate and other parameters in the half-procedure group were significantly lower than those in the whole-procedure group(P < 0.05),while knee function score 5 days after surgery was higher than that in the whole-procedure group,with statistical significance(P < 0.05).The incidence of postoperative thrombosis in thehalf-course group was lower than that in the whole-course group,and the difference was statistically significant(P < 0.05).However,there was no significant difference in postoperative superficial wound infection and other related complications between the two groups(P > 0.05).The D-2 polymer and CRP values in the whole group were higher than those in the half group,and the difference was statistically significant(P < 0.05).Conclusion: The use of tourniquets only during prosthetic installation does not increase total blood loss,and is beneficial to patients with reduced postoperative pain,lower limb swelling rate,improved knee score,and reduced incidence of postoperative thrombus and inflammatory reaction.