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After early release of tourniquet in total knee arthroplasty, should it be reinflated or kept deflated? A randomized trial

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study was undertaken to determine the efficacy of reinflation of the tourniquet after its early release in TKA compared to early release alone, in terms of surgical field visualization and operative time. We also questioned whether tourniquet reinflation after its early release is safe, with respect to post-operative blood loss, post-operative pain and other tourniquet-related complications.

Methods

Two hundred and six patients undergoing TKA were randomly allocated to either the early release (deflation) group (n = 105) or reinflation after early release (reinflation) group (n = 101). Efficacy was measured in terms of surgical field visualization, specifically the number of wound clearances, and operative time. Safety outcomes were drained volume, decline in haemoglobin on post-operative days 2 and 5, the frequency of transfusion, knee and thigh pain visual analog scale, local wound complications, tourniquet site complications and other complications, including infection, deep vein thrombosis and pulmonary embolism.

Results

Surgical field visualization was better in the reinflation group; however, the operative time did not differ between the two groups. There were no differences between the two groups in post-operative blood loss, decline in haemoglobin on days 2 and 5, transfusion rate, pain level, local complications and other complications.

Conclusion

Reinflation of tourniquet is a safe alternative to its early release after deflation in that it improves surgical field visualization during TKA.

Level of evidence

Therapeutic study, Level I.

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Authors and Affiliations

  1. Joint Reconstruction Center, Seoul National University Bundang Hospital, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Republic of Korea

    Young Gon Na, Ankur B. Bamne & Tae Kyun Kim

  2. Department of Orthopaedic Surgery and the Joint and Arthritis Research, Himchan Hospital, 404-3, Mok-dong, Yangcheon-gu, Seoul, 158-806, Republic of Korea

    Ho Hyun Won

  3. Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea

    Tae Kyun Kim

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  1. Young Gon Na
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  2. Ankur B. Bamne
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Correspondence to Tae Kyun Kim.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Na, Y.G., Bamne, A.B., Won, H.H. et al. After early release of tourniquet in total knee arthroplasty, should it be reinflated or kept deflated? A randomized trial. Knee Surg Sports Traumatol Arthrosc 25, 2769–2777 (2017). https://doi.org/10.1007/s00167-015-3710-9

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  • DOI: https://doi.org/10.1007/s00167-015-3710-9

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