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. 2013 May;37(5):827-32.
doi: 10.1007/s00264-013-1826-4. Epub 2013 Feb 16.

Tourniquet time affects postoperative complications after knee arthroplasty

Charlotta Olivecrona  1 , Lasse J Lapidus, Lina Benson, Richard Blomfeldt
Affiliations

Tourniquet time affects postoperative complications after knee arthroplasty

Charlotta Olivecrona et al. Int Orthop. 2013 May.

Abstract

Purpose: Pneumatic tourniquets are frequently used in knee arthroplasty surgery. However, there is a lack of evidence to define safe tourniquet time in lower limb surgery. The primary aim of this study was to investigate whether tourniquet time influences the risk of postoperative complications after primary and secondary knee arthroplasty.

Methods: This study was a prospective register study. Since we wanted dispersion in tourniquet time, we included a consecutive series of 577 primary knee arthroplasties, 46 revision knee arthroplasties, and 18 patellar supplementing knee arthroplasties from a clinical audit database over a period of five years. The following postoperative complications were recorded: superficial wound infections, deep wound infections, deep vein thrombosis, pulmonary embolism, nerve injuries, compartment syndrome, cuff pressure injuries, and bandage injuries.

Results: Tourniquet time over 100 minutes was associated with an increased risk of complications after knee arthroplasty surgery (OR 2.2, CI 1.5-3.1). This increase in risk remained after adjusting for cuff pressure, sex, age, American Society of Anesthesiologists (ASA) classification, smoking, diabetes, and surgery indication (OR 2.4, CI 1.6-3.6).

Conclusions: Tourniquet time over 100 minutes increases the risk of complications after knee arthroplasty surgery and special attention is advocated to reduce the tourniquet time.

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Figures

Fig. 1
Fig. 1
Multivariable odds ratio (OR) for suffering a complication by subgroups and p values are for interactions between tourniquet time ≤ 100 min vs. > 100 min and sex, age, ASA, surgery indication, diabetes, smokers, and cuff pressure. Numbers of complications by subgroups
See this image and copyright information in PMC

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