THIGH PAIN FOLLOWING TOURNIQUET APPLICATION IN SIMULTANEOUS BILATERALTOTAL KNEE REPLACEMENT ARTHROPLASTY

Thigh pain following tourniquet application is a common patient compla int in the early postoperative period following total knee arthroplast y. Postoperative thigh pain was evaluated in 28 consecutive simultaneo us bilateral total knee arthroplasty patients between April 1996 and O ctober 1996. A prospective, double-blind, randomized clinical trial wa s performed. Tourniquet pressure of 350 mmHg was used on 1 thigh (thig h 1) and 100 mmHg plus systolic blood pressure on the other (thigh 2). A scale of pain (no pain, mild, moderate, or severe) was applied on t he first, second, and third days, as well as 2 and 6 weeks after surge ry. There were 16 men and 12 women with a mean age of 72 years (range, 55-85 years). The mean tourniquet time was similar in both groups (th igh 1 = 23 minutes, thigh 2 = 22 minutes). The mean tourniquet pressur e in thigh 2 was 230 mmHg (range, 212-260 mmHg). There was a statistic ally significant difference in thigh pain on the first (P = .01), seco nd (P = .01), and third (P = .001) postoperative days between both gro ups, with more thigh pain on the 350 mmHg side. At 6 weeks after surge ry, the difference in thigh pain was gone. For total knee arthroplasty , using the tourniquet at a pressure of 100 mmHg above the systolic bl ood pressure is recommended. This is adequate to provide a bloodless f ield and will result in a less unpleasant postoperative period.