• A M Tetro and J F Rudan.
• Department of Surgery, Queen's University, Kingston, Ont.
• Can J Surg. 2001 Feb 1; 44 (1): 33-8.

ObjectiveIn lower-extremity surgery there are significant risks associated with the use of tourniquets. This prospective study was done to assess to what extent these risks may be offset by the potential advantages of tourniquets, namely reductions in blood loss, length of hospital stay and complication rates.DesignA prospective case study.SettingA major urban hospital.PatientsSixty-three consecutive patients scheduled for primary cemented total knee arthroplasty (TKA) were blindly randomized into tourniqet (n = 33) and non-tourniquet (n = 30) groups.InterventionTKA during which a pneumatic tourniquet was applied or not applied to control blood loss.Main Outcome MeasuresPerioperative blood loss, operating time, complication rates, hospital stay and transfusion needs.ResultsDifferences in the total measured blood loss, intraoperative blood loss and the Hemovac drainage blood loss between the 2 groups were not significantly different (p > 0.25). The calculated total blood loss was actually lower in the non-tourniquet group (p = 0.02). Between the groups there were no statistical differences in surgical time, length of hospital stay, transfusion requirements or rate of complications (although there was a trend to more complications in the tourniquet group (p = 0.06)).ConclusionThe effectiveness of a pneumatic tourniquet to control blood loss in TKA is questionable.

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