[Assessment of bleeding and operative time in total knee arthroplasty with and without tourniquet. Comparative study]

The use of the pneumatic tourniquet (PT) in total knee arthroplasty (TKA) has been controversial; its advantages, disadvantages and associated complications have been described. In order to assess its benefits we analyzed operative time; intraoperative, postoperative and total bleeding volume, as well as pre- and postoperative hemoglobin and hematocrit values in patients who had undergone primary TKA using the PT, and they were compared with a control group.

A retrospective analysis of the clinical records of cases who underwent TKA was conducted. Based on the inclusion criteria and the use or nonuse of PT, two groups were formed: a study group (n=19) and a control group (n=19). The following variables were compared: operative time, intra and postoperative bleeding and total bleeding; initial and final hemoglobin and hematocrit values.

Significant differences in favor of the group with PT use were obtained in 7 out of the 8 variables studied. The most relevant ones were operative time (t = 2.08 p < 0.050); intraoperative bleeding (t = -6.44, p < 0.010); postoperative bleeding (t = -2.170 p < 0.050) and total bleeding (t = /7.52, p < 0.010).

The results showed that patients in whom PT was used during TKA had a shorter operative time, and their total, intra- and postoperative bleeding and the estimated, blood loss were lower than in controls. Additional suppositions on the benefits of PT warrant the conduction'of more prospective research studies.