Comparison of total blood loss between limited tourniquet use and conventional tourniquet use in total knee arthroplasty: a randomized controlled trial
Abstract Background This study examined the differences in total blood loss, the need for blood transfusions, length of hospital stay, wound grading scores, incidence of venous thromboembolism (VTE), and reoperation rates between conventional and limited tourniquet use during unilateral primary tota...
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BMC
2024-11-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-024-08058-w |
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| author | Pruk Chaiyakit Pheeranut Kabkaew Natthapong Hongku Pichayut Wattanapreechanon |
| author_facet | Pruk Chaiyakit Pheeranut Kabkaew Natthapong Hongku Pichayut Wattanapreechanon |
| author_sort | Pruk Chaiyakit |
| collection | DOAJ |
| description | Abstract Background This study examined the differences in total blood loss, the need for blood transfusions, length of hospital stay, wound grading scores, incidence of venous thromboembolism (VTE), and reoperation rates between conventional and limited tourniquet use during unilateral primary total knee arthroplasty (TKA). Methods This double-blind, randomized controlled trial included 90 patients undergoing unilateral primary TKA. Forty-five patients were allocated to the limited tourniquet use group (LIM-TKA), and 45 to the conventional tourniquet use group (CON-TKA). The study analyzed differences in total blood loss, the need for blood transfusions, wound grading scores, incidence of VTE, length of hospital stay, and reoperation rates. Results The mean total blood loss in the LIM-TKA group was 589.55 ± 238.2 ml, significantly lower than the 692.31 ± 276.15 ml observed in the CON-TKA group (P = 0.031). Significantly poorer wound grades were seen in the CON-TKA group compared to the LIM-TKA group, with 23 vs. 34, 15 vs. 11, 5 vs. 0, 1 vs. 0 and 1 vs. 0 patients, respectively, having grade 1, 2 A, 2B, 2 C and 3 A wounds according to the Southampton Scoring System (P = 0.032). Patients in the LIM-TKA group also had a shorter hospital stay versus the CON-TKA group (5.6 ± 1.28 vs. 7.2 ± 4.06 days, P = 0.006). The rates of blood transfusion, VTE complications, and reoperation were similar between both groups. Conclusion LIM-TKA results in significantly lower total blood loss and improved wound grading scores, as well as a decreased length of hospital stay compared to CON-TKA. LIM-TKA could be a suitable option for surgeons aiming to minimize tourniquet-related adverse outcomes while maintaining a dry bone surface during TKA cementation. Clinical trial number This study was retrospectively registered at Thai Clinical Trials Registry (thaiclinicaltrials.org) on July 28, 2024. Clinical trial number: TCTR20240728002. |
| format | Article |
| id | doaj-art-060a456813ee40c8ad66d4e257a920c8 |
| institution | DOAJ |
| issn | 1471-2474 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-060a456813ee40c8ad66d4e257a920c82025-08-20T03:04:17ZengBMCBMC Musculoskeletal Disorders1471-24742024-11-012511710.1186/s12891-024-08058-wComparison of total blood loss between limited tourniquet use and conventional tourniquet use in total knee arthroplasty: a randomized controlled trialPruk Chaiyakit0Pheeranut Kabkaew1Natthapong Hongku2Pichayut Wattanapreechanon3Department of Orthopaedics, Faculty of Medicine Vajira Hospital, Navamindradhiraj UniversityDepartment of Orthopaedics, Faculty of Medicine Vajira Hospital, Navamindradhiraj UniversityDepartment of Orthopaedics, Faculty of Medicine Vajira Hospital, Navamindradhiraj UniversityDepartment of Orthopaedics, Faculty of Medicine Vajira Hospital, Navamindradhiraj UniversityAbstract Background This study examined the differences in total blood loss, the need for blood transfusions, length of hospital stay, wound grading scores, incidence of venous thromboembolism (VTE), and reoperation rates between conventional and limited tourniquet use during unilateral primary total knee arthroplasty (TKA). Methods This double-blind, randomized controlled trial included 90 patients undergoing unilateral primary TKA. Forty-five patients were allocated to the limited tourniquet use group (LIM-TKA), and 45 to the conventional tourniquet use group (CON-TKA). The study analyzed differences in total blood loss, the need for blood transfusions, wound grading scores, incidence of VTE, length of hospital stay, and reoperation rates. Results The mean total blood loss in the LIM-TKA group was 589.55 ± 238.2 ml, significantly lower than the 692.31 ± 276.15 ml observed in the CON-TKA group (P = 0.031). Significantly poorer wound grades were seen in the CON-TKA group compared to the LIM-TKA group, with 23 vs. 34, 15 vs. 11, 5 vs. 0, 1 vs. 0 and 1 vs. 0 patients, respectively, having grade 1, 2 A, 2B, 2 C and 3 A wounds according to the Southampton Scoring System (P = 0.032). Patients in the LIM-TKA group also had a shorter hospital stay versus the CON-TKA group (5.6 ± 1.28 vs. 7.2 ± 4.06 days, P = 0.006). The rates of blood transfusion, VTE complications, and reoperation were similar between both groups. Conclusion LIM-TKA results in significantly lower total blood loss and improved wound grading scores, as well as a decreased length of hospital stay compared to CON-TKA. LIM-TKA could be a suitable option for surgeons aiming to minimize tourniquet-related adverse outcomes while maintaining a dry bone surface during TKA cementation. Clinical trial number This study was retrospectively registered at Thai Clinical Trials Registry (thaiclinicaltrials.org) on July 28, 2024. Clinical trial number: TCTR20240728002.https://doi.org/10.1186/s12891-024-08058-wTourniquetsTotal knee arthroplastyBlood lossBlood transfusionWoundLength of stay |
| spellingShingle | Pruk Chaiyakit Pheeranut Kabkaew Natthapong Hongku Pichayut Wattanapreechanon Comparison of total blood loss between limited tourniquet use and conventional tourniquet use in total knee arthroplasty: a randomized controlled trial BMC Musculoskeletal Disorders Tourniquets Total knee arthroplasty Blood loss Blood transfusion Wound Length of stay |
| title | Comparison of total blood loss between limited tourniquet use and conventional tourniquet use in total knee arthroplasty: a randomized controlled trial |
| title_full | Comparison of total blood loss between limited tourniquet use and conventional tourniquet use in total knee arthroplasty: a randomized controlled trial |
| title_fullStr | Comparison of total blood loss between limited tourniquet use and conventional tourniquet use in total knee arthroplasty: a randomized controlled trial |
| title_full_unstemmed | Comparison of total blood loss between limited tourniquet use and conventional tourniquet use in total knee arthroplasty: a randomized controlled trial |
| title_short | Comparison of total blood loss between limited tourniquet use and conventional tourniquet use in total knee arthroplasty: a randomized controlled trial |
| title_sort | comparison of total blood loss between limited tourniquet use and conventional tourniquet use in total knee arthroplasty a randomized controlled trial |
| topic | Tourniquets Total knee arthroplasty Blood loss Blood transfusion Wound Length of stay |
| url | https://doi.org/10.1186/s12891-024-08058-w |
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