THE EFFECTS OF EARLY TOURNIQUET RELEASE DURING TOTAL KNEE ARTHROPLASTY - A PROSPECTIVE RANDOMIZED DOUBLE-BLIND-STUDY

We studied the effects of the timing of tourniquet release in 88 patie nts randomly allocated for release after wound closure and bandaging ( group A), or before the quadriceps layer had been closed allowing cont rol of bleeding before suture (group B), The groups were similar in me an age, weight, gender, preoperative knee score, radiographic grading, and prosthesis implanted,. Patients in group B had less postoperative pain, achieved earlier straight-leg raising, and had fewer wound comp lications, Five patients in group A had to return to theatre, three fo r manipulation under anaesthesia, one for secondary closure of wound d ehiscence, and one for drainage of a haematoma, The last patient later developed a deep infection, which was treated by a two-stage revision , There were no significant differences between the two groups in oper ating time, or the decrease in haemoglobin concentration at 48 hours p ostoperatively. Some of the adverse effects of the use of a tourniquet for knee surgery can be significantly reduced by early tourniquet rel ease, with haemostasis before the quadriceps mechanism and the wound a re closed.