An effective method to reduce ischemia time during total knee arthroplasty
Because of controversy regarding timing of tourniquet release during total knee arthroplasty (TKA), a closed arthrotomy as a tamponade for effective hemostasis was used to save ischemia time. The study was to verify the safety and efficacy on clinical issues. Methods: A prospective cohort study was...
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doaj-dae46f2aead94b1db64e45c8a20d05ca2020-11-24T22:35:22ZengElsevierJournal of the Formosan Medical Association0929-66462012-01-011111192310.1016/j.jfma.2012.01.006An effective method to reduce ischemia time during total knee arthroplastyChih-Wei ChangSheng-Min LanTa-Wei TaiKuo-An LaiChyun-Yu YangBecause of controversy regarding timing of tourniquet release during total knee arthroplasty (TKA), a closed arthrotomy as a tamponade for effective hemostasis was used to save ischemia time. The study was to verify the safety and efficacy on clinical issues. Methods: A prospective cohort study was conducted on 72 consecutive unilateral primary TKAs. They were divided into two groups according to different timing of tourniquet release. The study group was composed of 36 index procedures with an intra-operative release after a tight arthrotomy closure; while the remaining 36 TKAs with a tourniquet application throughout the procedure comprised the comparative group. In all operations, no drain was used to augment the intra-articular tamponade. Results: In the study group, the tourniquet time was significantly shorter (p<0.001), and thus ischemic duration and perioperative blood loss were reduced. The postoperative course was similar on the basis of analgesics consumption and inpatient stay, but better earlier functional recovery as well as subjective performance was observed at early postoperative follow-ups. Conclusions: The results suggest that a closed tamponade with arthrotomy closure and drainage avoidance is an effective hemostasis to reduce ischemia time during TKAs.http://www.sciencedirect.com/science/article/pii/S0929664612000101hemostasisreleasetamponadetotal knee arthroplastytourniquet |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Chih-Wei Chang Sheng-Min Lan Ta-Wei Tai Kuo-An Lai Chyun-Yu Yang |
spellingShingle |
Chih-Wei Chang Sheng-Min Lan Ta-Wei Tai Kuo-An Lai Chyun-Yu Yang An effective method to reduce ischemia time during total knee arthroplasty Journal of the Formosan Medical Association hemostasis release tamponade total knee arthroplasty tourniquet |
author_facet |
Chih-Wei Chang Sheng-Min Lan Ta-Wei Tai Kuo-An Lai Chyun-Yu Yang |
author_sort |
Chih-Wei Chang |
title |
An effective method to reduce ischemia time during total knee arthroplasty |
title_short |
An effective method to reduce ischemia time during total knee arthroplasty |
title_full |
An effective method to reduce ischemia time during total knee arthroplasty |
title_fullStr |
An effective method to reduce ischemia time during total knee arthroplasty |
title_full_unstemmed |
An effective method to reduce ischemia time during total knee arthroplasty |
title_sort |
effective method to reduce ischemia time during total knee arthroplasty |
publisher |
Elsevier |
series |
Journal of the Formosan Medical Association |
issn |
0929-6646 |
publishDate |
2012-01-01 |
description |
Because of controversy regarding timing of tourniquet release during total knee arthroplasty (TKA), a closed arthrotomy as a tamponade for effective hemostasis was used to save ischemia time. The study was to verify the safety and efficacy on clinical issues.
Methods: A prospective cohort study was conducted on 72 consecutive unilateral primary TKAs. They were divided into two groups according to different timing of tourniquet release. The study group was composed of 36 index procedures with an intra-operative release after a tight arthrotomy closure; while the remaining 36 TKAs with a tourniquet application throughout the procedure comprised the comparative group. In all operations, no drain was used to augment the intra-articular tamponade.
Results: In the study group, the tourniquet time was significantly shorter (p<0.001), and thus ischemic duration and perioperative blood loss were reduced. The postoperative course was similar on the basis of analgesics consumption and inpatient stay, but better earlier functional recovery as well as subjective performance was observed at early postoperative follow-ups.
Conclusions: The results suggest that a closed tamponade with arthrotomy closure and drainage avoidance is an effective hemostasis to reduce ischemia time during TKAs. |
topic |
hemostasis release tamponade total knee arthroplasty tourniquet |
url |
http://www.sciencedirect.com/science/article/pii/S0929664612000101 |
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