Excellent Clinical Outcomes in Total Knee Arthroplasty Performed Without a Tourniquet

Although tourniquet use is the standard protocol for total knee arthroplasties it may lead to postoperative complications including thigh pain, compressive soft-tissue problems, and thromboembolic events. The purpose of this study was to explore the perioperative and clinical outcomes of total knee arthroplasty performed without a tourniquet. Thirty consecutive total knee arthroplasties were performed in 30 patients without a tourniquet and compared with 30 procedures (30 matched patients) performed with a tourniquet. Tourniquet patients had statistically lower mean intraoperative blood loss, total blood loss, and change in hematocrit, but these did not have any clinical impact or change the transfusion rate between the groups. At a mean follow-up of 3 years, both groups achieved excellent mean Knee Society scores with similar improvements between groups. There were no complications or radiographic abnormalities in either group. Total knee arthroplasty performed with or without a tourniquet yields similar intraoperative surgical and postoperative clinical outcomes.