The Effects of Timing of Tourniquet Release on Blood Loss in Navigation Assisted Total Knee Arthroplasty

Kwang Kyoun Kim; Ye Yeon Won; Hyeong Tak Oh; Dae Hee Lee

doi:10.4055/jkoa.2013.48.1.16

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Kim, Won, Oh, and Lee: The Effects of Timing of Tourniquet Release on Blood Loss in Navigation Assisted Total Knee Arthroplasty

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2013; 48(1): 16-21.

Published online: 26 February 2013

DOI: https://doi.org/10.4055/jkoa.2013.48.1.16

The Effects of Timing of Tourniquet Release on Blood Loss in Navigation Assisted Total Knee Arthroplasty

Kwang Kyoun Kim, M.D., Ye Yeon Won, M.D.^*, Hyeong Tak Oh, M.D., Dae Hee Lee, M.D.

Department of Orthopedic Surgery, Konyang University College of Medicine, Daejeon, Korea.

^*Department of Orthopedic Surgery, Ajou University School of Medicine, Suwon, Korea.

Correspondence to: Dae Hee Lee, M.D. Department of Orthopedic Surgery, Konyang University Hospital, 158, Gwanjeodong-ro, Seo-gu, Daejeon 302-812, Korea. TEL: +82-42-600-6902, FAX: +82-42-545-2373, ajouos@hanmail.net

Received 13 June 2012 Revised 15 September 2012 Accepted 11 December 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The aim of this study is to evaluate the effects of timing of tourniquet release on blood loss in navigation assisted total knee arthroplasty.

Materials and Methods

A total of 63 consecutive patients, who underwent navigation assisted total knee arthroplasty, were divided into two groups; 31 patients (31 knees, group I) were operated with tourniquet release after wound closure and applied compression dressing, and another 32 patients (32 knees, group II) were operated with tourniquet release and hemostasis before implantation of the polyethylene insert. We examined hemoglobin concentration and hematocrit at three points in time, preoperatively, 24 hours and 48 hours postoperatively. We compared the two groups of patients in terms of total blood loss, postoperative drained blood loss, hidden blood loss, visible blood loss and operation time.

Results

There were no significant differences between the two groups in the hemoglobin concentration at 24 hours and 48 hours postoperatively (p=0.371, p=0.247), and hematocrit at 24 hours and 48 hours postoperatively (p=0.428, p=0.125). No statistically significant differences between the two groups in the postoperative drained blood loss (p=0.381) and total blood loss (p=0.126) were found. We found statistically significant differences in the visible blood loss (p=0.023), hidden blood loss (p=0.045) and operation time (p=0.005).

Conclusion

The releasing time of tourniquet have no effect on the actual total blood loss, and postoperative drained blood loss in navigation assisted total knee arthroplasty. We concluded that compared with intraoperative tourniquet release, postoperative tourniquet release are useful for making the broader operation field and less operation time.

Keywords: knee, navigation, arthroplasty, tourniquets, blood loss

Figures and Tables

Table 1

Patient Characteristics for Two Groups

Values are presented as number or raw mean±standard deviation. The date is analyzed by Pearson's chi-square and Student's t-test statistical method. BMI, body mass index; Hb, hemoglobin; HCT, hematocrit.

Table 2

Effects of Tourniquet Use on Hb, HCT and Blood Loss, Tourniquet Time

Values are presented as raw mean±standard deviation. The date is analyzed by Student's t-test statistical method. ^*Volume gathered for postoperative 24 hours; ^†to postoperative 24 hours; ^‡time from skin incision to wound closed. Hb, hemoglobin; HCT, hematocrit.

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