Timing Of Tourniquet Release In Total Knee Arthroplasty And Early Rehabilitation:a Clinical Research

Objective:The objective of the research is to evaluate the early rehabilitation in relation to tourniquet release before wound closure for hemostasis or after wound closure in Total Knee Arthroplasty.Methods:From June1,2014to January31,2015,80knee osteoarthritis patients who underwent TKA at Zhejiang University School of Medicine, Second Affiliated Hospital were chosen in the research. In the80cases,40tourniquets were released before wound closure for hemostasis, and others released after wound closure. The research based on medical records system was a retrospective study. We compared average operating time and blood loss, non-surgical disposable medical materials and post-operative hospital stay, laboratory results, RBC loss, functional training of Contionuous Passive Motion, complication such as infection and deep venous thrombosis between two groups.Results:Compared with the group of tourniquet release after wound closure, the main disadvantages of tourniquet release before wound closure group were prolonging operative time (68.68±10.73v.s.87.65±11.45min; P<0.001) and increasing intraoperative blood loss (97.88±39.89v.s.127.50±49.29mL; P=0.004). Its main advantages included reducing the total (53.73±147.38v.s.344.51±125.88mL; P=0.017) and recessive (310.40±137.68v.s.215.13±119.31mL; P=0.025) loss of red blood cells, shortening hospital stays (9.60±3.42v.s.7.05±2.89d; P=0.001) and accelerating post-operative functional recovery of CPM (4.74±1.69v.s.4.00±1.11d; P=0.028). There was no significant difference in the perioperative transfusion rates and the dominant red blood cell loss between two groups.Conclusion:The application of tourniquet in TKA has been accepted by a number of joint surgeons. Tourniquet releasing before wound closure in TKA, not only reduce perioperative blood loss, but also shorten hospital stays and be benefit for patients on early exercise.