Desenlaces del reemplazo total de rodilla con y sin torniquete: un estudio de cohorte

Gabriel Narváez-Rodríguez; José Reyes-Copello; Álvaro Reyes-Trujillo; Alfredo Castro-Dangond; Sofía Muñoz-Medina

doi:10.58814/01208845.28

Authors

Gabriel Narváez-Rodríguez Clínica Universitaria Colombia, Orthopedics Department, Bogotá D.C., Colombia. https://orcid.org/0000-0001-8776-1280
José Reyes-Copello Clínica Universitaria Colombia, Orthopedics Department, Bogotá D.C., Colombia. https://orcid.org/0000-0002-4099-5992
Álvaro Reyes-Trujillo Clínica Universitaria Colombia, Orthopedics Department, Bogotá D.C., Colombia. https://orcid.org/0000-0001-9875-0181
Alfredo Castro-Dangond Clínica Universitaria Colombia, Orthopedics Department, Bogotá D.C., Colombia. https://orcid.org/0000-0002-0312-037X
Sofía Muñoz-Medina Fundación Universitaria Sanitas, Research Unit, Bogotá D.C., Colombia. https://orcid.org/0000-0002-8038-298X

DOI:

https://doi.org/10.58814/01208845.28

Keywords:

Arthroplasty, Osteoarthritis, Knee, Arthroplasty, Replacement, Knee, Tourniquets, Postoperative Complications

Abstract

Introduction: Pneumatic tourniquet is commonly used during total knee replacement (TKR) surgery; however, this practice has been associated with complications derived from ischemia, making its use controversial.

Objective: To compare clinical and functional outcomes and frequency complications at 90 days in patients undergoing TKR with and without a tourniquet.

Methodology: Retrospective cohort study, including 393 patients with grade III and IV gonarthrosis who underwent primary TKR surgery with and without the use of a pneumatic tourniquet in two medical centers of Bogotá between 2014 and 2021, who were followed up for at least 90 days. Bivariate analyses (Student's t-tests, Mann-Whitney U and chi-square) were performed to establish differences between groups (with tourniquet versus without tourniquet).

Results: The median age was 67 years (interquartile range: 61-74 years) and 68.96% of the patients were women. A tourniquet was used in 45.80% and 2.54% presented some complication. Postoperative hematocrit loss (760ml vs. 679ml; p=0.13) and percentage of hemoglobin loss (17.8% vs. 17.1%; p=0.33) were higher in the TKR group in which no tourniquet was used. No statistically significant differences were found between groups in terms of pain, range of motion, duration of surgery, and presence of complications (p>0.05).

Conclusions: Conclusions. No significant differences were found between the use or non-use of tourniquet during TKR surgery in terms of pain, bleeding, range of motion, duration of surgery, and frequency of complications.

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