Volume VII, Number 1 | April 2023

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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