Volume VI, Number 1 | March 2022

Effect of Prolonged Tourniquet Use on Complications and Patient Satisfaction Following TKA

1Presley T, 1Mazzocco J, 1Granade M, 2Smith L, 1Malkani A
1University of Louisville, Louisville, KY, United states; 2UofL Health, Louisville, KY, United states

As the number of total knee arthroplasties (TKA) performed yearly continues to increase, there has been a greater interest in the factors that affect patient outcomes. Purpose of this study is to determine if prolonged tourniquet time affects patient satisfaction and other patient-reported outcome measures (PROMs).

A retrospective cohort review was performed on unilateral, cementless TKA. 198 consecutive TKAs were reviewed and 186 TKAs met study inclusion criteria: BMI<40, minimum 2-year follow-up. Patients were stratified into two cohorts: 91 TKAs had tourniquet time less than 60 minutes (Group A) and 95 TKAs with a prolonged tourniquet time (greater than 60 minutes – Group B). Patient satisfaction scores using a 5-point Likert scale were collected at 1 and 2-year follow-up. PROMs including Knee Society Score (KSS), Forgotten Joint Score (FJS-12), and KOOS JR. were collected at 2-year follow-up. Active range of motion (AROM) and postoperative complications were evaluated. Statistical analysis performed using t-test.

Mean patient satisfaction in Group A versus B did not differ at postoperative year 1 (4.6 vs 4.6; P=0.42) or year 2 (4.7 vs 4.7; P=0.42). AROM at postoperative year 2 was 121 in Group A and 119.3 in those in Group B (P=0.037). 2-year PROMs between patients in Group A and Group B: KSS Function 86.4 vs 87, P=0.4; KSS Knee 93.7 vs 90.2, P=0.01; KOOS JR 87.1 vs 87.2, P=0.48; FJS 73.3 vs 74.5, P=0.39. 13 patients in Group A had a postoperative complication compared to 19 in Group B (P=0.15).

There were no differences in patient satisfaction or complications at postoperative years 1 and 2 in patients who underwent TKA with tourniquet time less than 60 minutes and those with prolonged tourniquet time. There was a slightly higher KSS Knee score in the group with less than 60 minutes tourniquet time.

The Journal of the American Osteopathic Academy of Orthopedics

Steven J. Heithoff, DO, FAOAO

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Authors in This Edition

J. Michael Anderson BS, OMS IV
Rigel Bacani BA, BS, OMS II
David Beckett OMS I
Bhakti Chavan MBBS, MPH
Jake Checketts DO
Grant Chudik OMS II
Adam Dann
Marc Davidson MD
Clinton J. Devin MD
Jeffrey Dulik DO
Bryan Dunford BS, OMS II
Diego Galindo DO
Gregory Galvin DO
Curtis Goltz DO

Jordan Grilliot DO
Brian Handal
Safet Hatic
Scott Dean Hodges DO
David Houserman DO
Jenna Jarrell MS IV
Michael Jones DO
Anthony Kamson DO
Tyler Metcalf MS IV
Anna Elisa Muzio DO
Cesar Cornejo Ochoa OMS I
Brandi Palmer MS
Joseph Patrick
David Phillips DO

Jonathan Phillips MD
Kornelis Poelstra MD
Jesse Raszewski DO, MS
Katherine Sage DO
Steven Santanello DO, FAOAO
Jared Scott DO
Julieanne Sees
James Seymour DO
Jonathan Schneider DO
John Alex Sielatycki MD
Benjamin Taylor MD, FAAOS
Trevor Torgerson BS, OMS IV
Phong Truong DO
Matt Vassar PhD