DOI: https://doi.org/10.22263/2312-4156.2024.2.51
Y.K. Khadzkou1, K.B. Balaboshka2, V.P. Deikala1, Y.V. Khadzkova1, U.P. Khmelchanka1, A.Y. Tsarkouski2
Pneumatic tourniquet in knee arthroplasty: to apply or not?
1Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
2Vitebsk Regional Clinical Hospital, Vitebsk, Republic of Belarus
Vestnik VGMU. 2024;23(2):51-58.
Abstract.
Objectives. To determine the efficacy and safety of using a pneumatic tourniquet in primary total knee arthroplasty.
Material and methods. 70 patients who underwent total knee arthroplasty were included in prospective randomized study. For patients in group 1, the operation was performed using a pneumatic tourniquet, for patients in group 2, the operation was performed without using it. The following indicators were assessed in the groups: hemoglobin level, the number of red blood cells, hematocrit, the volume of perioperative blood loss, pain syndrome severity according to the visual analogue scale, the range of active movements in the knee joint, the operation duration, the number of complications in the postoperative period.
Results. In the postoperative period, no statistically significant intergroup differences were found in the level of hemoglobin, the number of red blood cells, hematocrit, the volume of perioperative blood loss, the severity of pain syndrome, the functional outcome and the number of complications. The average duration of surgery in patients with the pneumatic tourniquet use was 70 [60; 75] minutes, whereas in patients without using it – 75 [70; 85] minutes, which was statistically significantly longer (p<0.007).
Conclusions. The pneumatic tourniquet use in knee arthroplasty, provided that fibrinolysis inhibitors are used, is not associated with an increase in the volume of blood loss, the intensity of pain syndrome, the frequency of postoperative complications and a decrease in rehabilitation potential. Therefore, the final decision regarding the pneumatic tourniquet use can be made by an orthopedic surgeon on the basis of individual preferences and taking into account the specific clinical situation.
Keywords: knee arthroplasty, pneumatic tourniquet, blood loss, pain syndrome, rehabilitation.
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Information about authors:
Y.K. Khadzkou – Candidate of Medical Sciences, associate professor of the Chair of Traumatology & Orthopedics, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0002-9216-7929
e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Yauheni K. Khadzkou;
K.B. Balaboshka – Candidate of Medical Sciences, associate professor, traumatologist-orthopedist of the traumatology and orthopedic department No.1, Vitebsk Regional Clinical Hospital, https://orcid.org/0000-0002-5599-3439
V.P. Deikala – Doctor of Medical Sciences, professor, head of the Chair of Traumatology & Orthopedics, Vitebsk State Order of Peoples’ Friendship Medical University;
Y.V. Khadzkova – senior lecturer of the Chair of Anesthesiology and Resuscitation with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0009-0005-1567-3499
U.P. Khmelchanka – senior lecturer of the Chair of Traumatology & Orthopedics, Vitebsk State Order of Peoples’ Friendship Medical University;
A.Y. Tsarkouski – traumatologist-orthopedist of the traumatology and orthopedic department No.2, Vitebsk Regional Clinical Hospital.
