The influence of a half-course tourniquet strategy on peri-operative blood loss and early functional recovery in primary total knee arthroplasty

被引:64
作者
Chen, Sen [1 ,2 ]
Li, JianPing [1 ]
Peng, Hao [1 ]
Zhou, Jianlin [1 ]
Fang, Hongsong [1 ]
Zheng, Huifeng [1 ]
机构
[1] Wuhan Univ, Renmin Hosp, Dept Orthoped, Wuhan 430060, Hubei Province, Peoples R China
[2] Hubei Univ Med, Dongfeng Gen Hosp, Shiyan 442008, Hubei Province, Peoples R China
关键词
Total knee arthroplasty; Pneumatic tourniquet; Blood loss; Early functional recovery; DEEP-VEIN THROMBOSIS; RANDOMIZED CONTROLLED-TRIAL; TRANSESOPHAGEAL ECHOCARDIOGRAPHY; HIDDEN LOSS; RELEASE; ISCHAEMIA/REPERFUSION; THROMBOEMBOLISM; REPLACEMENT; MANAGEMENT; FIXATION;
D O I
10.1007/s00264-013-2177-x
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose The aim of this study was to explore the influence of a half-course tourniquet strategy on the peri-operative blood loss and early functional recovery in primary total knee arthroplasty. A prospective clinical randomised controlled study was carried out in which 64 patients were equally divided into two groups: half-course group and whole-course group. A series of indicators were observed and recorded. These included operation time, peri-operative blood loss, visual analogue scale (VAS) score of the thigh or knee, limb swelling index, rehabilitation progress and occurrence of deep venous thrombosis cases. There was no significant difference in operation time between the two groups. The intra-operative blood loss was slightly more in the half-course group, while the difference was not significant. The post-operative blood loss and calculated blood loss were less in the half-course group and the difference was significant. The thigh VAS score, limb swelling and time intervals required for patients to achieve straight leg raises and 90A degrees of knee flexion in the half-course group were better than in the whole-course group. No case of symptomatic deep venous thrombosis happened in this study, while occult incidence of deep venous thrombosis happened in both groups, but no significant difference between the groups was confirmed. The half-course tourniquet strategy could decrease the total peri-operative blood loss in primary total knee arthroplasty. It was beneficial in helping patients to achieve earlier functional recovery by improving the pain experience and limb swelling early in the post-operative period.
引用
收藏
页码:355 / 359
页数:5
相关论文
共 38 条
[21]  
Matziolis D, 2011, ORTHOPADE, V40, P178, DOI 10.1007/s00132-010-1727-9
[22]   Tourniquet application only during cement fixation in total knee arthroplasty: a double-blind, randomized controlled trial [J].
Mittal, Rajat ;
Ko, Victoria ;
Adie, Sam ;
Naylor, Justine ;
Dave, Jaykar ;
Dave, Chandrakant ;
Harris, Ian A. ;
Hackett, Danella ;
Ngo, David ;
Dietsch, Susan .
ANZ JOURNAL OF SURGERY, 2012, 82 (06) :428-433
[23]   Time course of thrombosis and fibrinolysis in total knee arthroplasty with tourniquet application. Local versus systemic activations [J].
Reikeras, Olav ;
Clementsen, Torkil .
JOURNAL OF THROMBOSIS AND THROMBOLYSIS, 2009, 28 (04) :425-428
[24]   Retrospective comparison of three thromboprophylaxis agents, edoxaban, fondaparinux, and enoxaparin, for preventing venous thromboembolism in total knee arthroplasty [J].
Sasaki, Hiroshi ;
Ishida, Kazunari ;
Shibanuma, Nao ;
Tei, Katsumasa ;
Tateishi, Hiroomi ;
Toda, Akihiko ;
Yamashiro, Yukiko ;
Matsumoto, Tomoyuki ;
Kuroda, Ryosuke ;
Kurosaka, Masahiro .
INTERNATIONAL ORTHOPAEDICS, 2014, 38 (03) :525-529
[25]  
Schousboe JT, 2013, J BONE JOINT SURG AM, V95A, P1256, DOI [10.2106/JBJS.L.00400, 10.2106/JBJS.L00400]
[26]  
Schuh A, 2003, ZBL CHIR, V128, P866
[27]   Hidden blood loss following hip and knee arthroplasty - Correct management of blood loss should take hidden loss into account [J].
Sehat, KR ;
Evans, RL ;
Newman, JH .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2004, 86B (04) :561-565
[28]   How much blood is really lost in total knee arthroplasty? - Correct blood loss management should take hidden loss into account [J].
Sehat, KR ;
Evans, R ;
Newman, JH .
KNEE, 2000, 7 (03) :151-155
[29]  
Stroh D Alex, 2011, Surg Technol Int, V21, P189
[30]   Effects of Tourniquet Use on Blood Loss and Soft-Tissue Damage in Total Knee Arthroplasty A Randomized Controlled Trial [J].
Tai, Ta-Wei ;
Chang, Chih-Wei ;
Lai, Kuo-An ;
Lin, Chii-Jeng ;
Yang, Chyun-Yu .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2012, 94A (24) :2209-2215