• Kai Zhou, Tingxian Ling, Haoyang Wang, Zongke Zhou, Bin Shen, Jing Yang, Pengde Kang, and Fuxing Pei.
• Department of Orthopaedics, West China Hospital of Sichuan University, Chengdu, 610041, China.
• J Orthop Surg Res. 2017 Nov 14; 12 (1): 172.

BackgroundWe aimed to compare the effect of tourniquet use or lack of it on recovery following uncomplicated primary total knee arthroplasty (TKA).MethodsIn a prospective randomised double-blinded study, 150 patients undergoing primary TKA were assigned to either a tourniquet or non-tourniquet group. At the early phase, 3 and 6 months after surgery, an independent observer assessed the primary outcome measure (i.e. total blood loss) and secondary outcome measures (i.e. wound complications, visual analogue scale pain score and knee range of motion).ResultsThe tourniquet group exhibited reduced intraoperative blood loss (215.7 ± 113.7 ml vs. 138.6 ± 93.9 ml, P < 0.001) and shorter operating time (77.2 ± 14.5 min vs. 82.0 ± 12.7 min, P = 0.038). However, the non-tourniquet group showed less postoperative blood loss (180.2 ± 117.0 ml vs. 253.7 ± 144.2 ml, P = 0.001) and drainage volume (89.2 ± 66.3 ml vs. 164.5 ± 97.8 ml, P = 0.004), less thigh pain (all P < 0.001) in the initial 3 weeks, better knee range of motion (ROM) in the initial 3 days (day 1 81.6 ± 17.1 vs. 75.95 ± 14.55, P = 0.036; day 3 99.8 ± 13.7 vs. 93.95 ± 11.15, P = 0.005) and fewer wound tension vesicles (10.3 vs. 29.2%, P = 0.005). Earlier straight-leg raising (4.6 ± 3.8 h vs. 6.4 ± 4.3 h, P = 0.01) and shorter length of stay (6.3 ± 1.7 days vs. 7.1 ± 1.9 days, P = 0.001) were found in the non-tourniquet group. Similar total blood loss and blood transfusion rate were observed for both groups. All other parameters revealed no significant differences.ConclusionsOur study suggests that a non-tourniquet TKA would lead to early rehabilitation without increasing side effects.Trial RegistrationChinese Clinical Trials Registry, ChiCTR-IOR-16007851 , 1/29/2016.

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