Intraoperative Different Tourniquetapplication Methods On Total Kneearthroplasty, Effect On Perioperative

Total Knee Replacement (TKR) comparing to the conservative therapy of kneediseases is a safe and efficiency method to lessen pain and knee function restructure.From the overall point of view the prospect of total knee arthroplasty is favored by theclinical doctors and scholars.Although the operation process has correlation withpatient’s health、prosthesis type、technique and experience of surgeon and surgicalequipment, et al, as a whole, TKR has lower operation risk and higher success rate.TKR has been recognized a effective method, its success rate has surpassed90％since15years [1].Later years in our country TKR has been widely used as a mature technique,however, because of difference in knee anatomic position、special structure and the levelof operator’s technique, it is easy to generate all kinds of post operation complicationinfluencing curative effect.Purposes: In order to better understand of TKR post operation complication lateryears in our hospital, we have had a analysis of the cases from Sep.2011to Feb.2014to discuss the cause、diagnosis and treatment.To study the perioperative period effects ofdifferent tourniquet use in total knee arthroplasty (TKA)．Methods:64cases (the patients were prospectively randomized) which weretreated with TKR from Sep.2011to Feb.2014were selected randomly. Including64Osteoarthritis. All of them have different grade of varus knee deformity (3°-40°).64patients were divided into two groups according to the different methods,“full-timetourniquet group (30cases)”used tourniquet from the beginning to the end，and “short—time tourniquet group (34eases)”used tourniquet45minutes at a time, Length ofsurgery，perioperative blood loss，volume of intraoperative transfusion， percent age offirst sit-up dizziness and complication were recorded． Hemoglobin was recordedpreoperatively and in postoperative1，3and14days, and the circumference of lowerextremity．VAS of around knee pain，and range of motion of knee joint were also recorded preoperatively and in postoperative3and14days． SPSS17.0statisticalanalysis, percentages and rates were compared using the X2testResults: There was nosignificantdifference inperioperative bloodloss．volumeofintraoperative transfusion, percentage of first sit-up dizziness， complication，hemoglobin and range of motion between these two groups (P>0.05)．Circumference oflower extremity at10cm above patellae were significantly decreased and VAS ofaround knee pain was significantly alleviated in part-time to tourniquet group (P<0．05)． Circumference of lower extremity at10cm below patellae were significantlydecreased at postoperative3and14days (P<0．05)．Conclusion:1.45minutes at a time using a tourniquet can reduce the post operativeswelling of thighs and legs，alleviate the postoperative pain around knee，and beadvantageous to the short-term postoperative knee function recovery．2.45minutes at a time using a tourniquet does not increaseperioperative blood loss.3.45minutes at a time using a tourniquet may be reduce the incidenceof venous thrombosis of lower limbs.