Philippine Orthopedic Center Research Board
To Exsanguinate or Not: A comparative study among Filipino Total Knee Arthroplasty patients with tourniquet applied after leg elevation versus manual exsanguination with elastic bandage
Aquilino Cresencio F. Pimentel V, MD, Joel Baron, MD
Podium Presentation: Philippine Orthopaedic Association, 74th Annual Convention, Edsa Shangrila, Mandaluyong City
2nd place, Podium Presentation: 29th Residents Research Forum,
Philippine Orthopedic Center, August 11, 2023
ABSTRACT
BACKGROUND
Osteoarthritis is a degenerative joint disease that involves the synovial joints such as the knees and the hips. It leads to inflammation, mechanical changes to the joints, and eventual functional decline. Total knee arthroplasty is a surgical procedure wherein the distal femur and proximal tibia are replaced with implants. The use of a tourniquet in total knee arthroplasty is a common practice amongst orthopedic surgeons. Exact guidelines as to how tourniquets are applied have not been established. This study seeks to compare post-operative pain, blood loss, occurrence of nerve injury, and length of surgery among patients with knee osteoarthritis who undergo TKA with tourniquet use after limb elevation versus exsanguination with use of elastic bandage.
METHODOLOGY
A single-center, prospective, comparative, randomized controlled study was performed in Philippine Orthopedic Center, a specialty government hospital. Participants included all Filipino patients aged 50-
80 years old with severe knee osteoarthritis that undergo any form of total knee arthroplasty. Patients were randomly added to two groups, one group had elevation method of tourniquet application, while the other group had manual exsanguination with elastic bandage use.
RESULTS
There was statistically no significant difference in post-op pain levels, blood loss, operative time, and occurrence of palsy between the two methods of tourniquet application.
DISCUSSION AND CONCLUSION
The method of tourniquet application for a total knee replacement does not significantly affect the post- operative pain of patients. It also does not significantly affect the operative time or blood loss. This study concludes that either method of tourniquet application is safe and has similar outcomes up to one-month post- surgery.