Usefulness of elastic pneumatic tourniquet cuff following total knee arthroplasty

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Created On: 19/10/2020

Usefulness of elastic pneumatic tourniquet cuff following total knee arthroplasty

This study aimed to assess the safety and efficacy of the pneumatic tourniquet system via an elastic cuff and limb occlusion pressure (LOP) in patients who experienced total knee arthroplasty (TKA).

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Key take away

Various complications arise due to tourniquet use, for example, thigh pain, skin problems, and deep vein thrombosis (DVT). Based on the hypothesis of this study i.e. an elastic cuff tourniquet would lead to less postoperative thigh pain following TKA, the use of elastic cuff and limb occlusion pressure (LOP) was proved effective in reducing thigh pain. The occurrence of proximal deep vein thrombosis was also lower with elastic cuff and LOP.

Background

This study aimed to assess the safety and efficacy of the pneumatic tourniquet system via an elastic cuff and limb occlusion pressure (LOP) in patients who experienced total knee arthroplasty (TKA).

Method

Ninety-eight patients who underwent primary TKA were randomized into 2 groups: Group E with tourniquet system via elastic cuff and LOP group and Group C with tourniquet system via conventional-cuff and LOP group.

Outcomes to be assessed included postoperative thigh pain evaluated by visual analogue scale (VAS), recommended tourniquet pressure (RTP), serum muscle enzymes, bloodlessness of surgical field, surgical period, the occurrence of deep vein thrombosis (DVT), and the rate of rescue analgesic usage post-surgery.

Result

On day 4 and 7 post-surgery, Group E patients experienced significantly less thigh pain than in Group C. A considerably lower difference between RTP and systolic blood pressure was observed in group E. Also, Group E had 1 case of thigh DVT, whereas no such cases were prevalent in Group C (table 1).

In Group E and Group C, 1 and 2 cases of poor bloodless surgical fields were detected. No significant differences concerning surgical period, serum muscle enzymes, and rescue analgesic usage between groups were found.

Conclusion

The use of elastic cuff and LOP tourniquet was useful in decreasing initial post-operative thigh pain more efficiently than the conventional approach.