The limited use of a tourniquet during total knee arthroplasty: a randomized controlled trial

Knee. 2014 Dec;21(6):1263-8. doi: 10.1016/j.knee.2014.08.002. Epub 2014 Sep 9.


Background: Total knee arthroplasty (TKA) is commonly performed using a tourniquet. However, some studies have reported that several complications were associated with the use of a tourniquet in TKA. In this study we investigate whether the limited use of a tourniquet in TKA would reduce complications and facilitate postoperative recovery.

Methods: Sixty patients were randomly divided into two groups (30 cases/group): group A using the tourniquet throughout the surgical procedure, and group B using the tourniquet starting from the cementation to the completion of the procedure. Operation time, total measured blood loss, and incidence of complications were all recorded.

Results: There was no significant difference in operation time, total measured blood loss, and hemoglobin concentration between the two groups. Incidence of postoperative complications in group B was significantly decreased in comparison to that in group A. The limb circumference at 10 cm above the superior patellar pole or below the inferior patellar pole and the pain score in group B were significantly decreased compared with that in group A at any time point. Range of motion in group B was significantly increased at three and 5 days postoperatively in comparison to that in group A.

Conclusions: The limited use of a tourniquet in TKA provides the benefit of decreased limb swelling and knee joint pain while not compromising the operation time or blood loss and recovery.

Level of evidence: Level I (Therapeutic).

Trial registration number: NCT02102581.

Keywords: Blood loss; Limb circumference; Limb swelling; Total knee arthroplasty; Tourniquet.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Knee / methods*
  • Blood Loss, Surgical / prevention & control*
  • Edema / prevention & control
  • Female
  • Hemostasis, Surgical / instrumentation
  • Hemostasis, Surgical / methods*
  • Humans
  • Male
  • Middle Aged
  • Operative Time
  • Pain, Postoperative / prevention & control
  • Postoperative Complications / prevention & control
  • Tourniquets*

Associated data