2017 ISAKOS Biennial Congress ePoster #1262

 

The Effects Of Using The Sterile Elastic Exsanguination Tourniquet On Bleeding, Infection And Rehabilitation For Total Knee Arthroplasty

Ahmet Ö. Yildirim, MD, Konya, Konya TURKEY
Mustafa Özer, ASISTAN, ANKARA TURKEY

Konya Beyhekim State Hospital. Konya Education and Research Hospital, Konya, TURKEY

FDA Status Cleared

Summary

Our study is the first article in the literature to examine the different advantages of sterile elastic exsanguination tourniquet compared to pneumatic tourniquet on total knee arthroplasty

ePosters will be available shortly before Congress

Abstract

Bloodless limb surgery was first introduced by Friedrich von Esmarch in 1873 and improved in 1908 by Dr. Cushing with the introduction of the pneumatic tourniquet. There are so many articles in the literature about the pneumatic tourniquets for total knee arthroplasty, but there are not enough knowledge about using sterile tourniquets for total knee artroplasty.
We compared the sterile elastic exsanguination tourniquet and the pneumatic tourniquet for total knee arthroplasty. We had planned to include 124 patients into the study but due to the lack of follow-up period; 8 patients were excluded from the study. 116 patients were included to the investigation which were operated between the years 2015 and 2016. 67 patients were operated on using a pneumatic tourniquet and 49 with the sterile elastic exsanguination tourniquet. Selected patients were operated in two different hospital with the same surgical crew.The results were compared in 4 diferent periods as the early , 1 month , 3 months and 6 months postoperative period. File records about the patients and the hospital documentation system were used to analyze the results. Mean decrease in hemoglobin, post-operative blood transfusion, the amount of blood that was drained from the intra-articular space, early and late range of motion scale and clinical-lab parameters about the infection were collected and compared.
The early flexion and extension rates were better in the sterile tourniquet group which was statistically significant. There were no significant differences between two groups for range of motion. Patients with the sterile tourniquet had a smaller decrease in hemoglobin on post-operative days and the amount of blood collected from drains at 24 h was significantly lower in the sterile elastic tourniquet group. There were no significant differences in the infection rates however a higher rate of wound complications following the operation were found in the pneumatic tourniquet group.
Our study is the first article in the literature to examine the different advantages of sterile elastic exsanguination tourniquet compared to pneumatic tourniquet on total knee arthroplasty. Sterile tourniquet is easy to use, effective and safe. With the increase of the number of patients that included to the study and longer follow-up time can give us more meaningful results.