Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
International Orthopaedics
Published in: International Orthopaedics 9/2016

01-09-2016 | Original Paper

Silicone ring tourniquet or pneumatic cuff tourniquet for total knee arthroplasty

Authors: Jean-Yves Jenny, David Bahlau, Sandra Wisniewski

Published in: International Orthopaedics | Issue 9/2016

Login to get access

Abstract

Purpose

The goal of the present study was to evaluate the potential advantages of a silicon ring tourniquet in comparison to the conventional pneumatic cuff tourniquet. The tested hypothesis was that the calculated blood loss will be decreased after use of the silicone ring tourniquet.

Methods

The study was monocentric and mixed retrospective and prospective evaluation of prospectively collected data. Inclusion criterion was implantation of a total knee arthroplasty. The retrospective control group involved 39 patients operated on with a pneumatic cuff tourniquet. The prospective study group involved 33 patients operated on with a silicone ring tourniquet. All patients were followed for three months. Primary criterion was the calculated blood loss (OSTHEO formula). Secondary criteria were pain on third post-op day, need for allogenic transfusion, haemoglobin drop, delay of discharge, and occurrence of complications.

Results

The mean calculated blood loss was 901 ml in the study group and 989 ml in the control group (NS). There was no significant difference in pain evaluation and haemoglobin drop between the two groups. There was a non significant decrease of allogeneic transfusion and length of stay in the study group. There was a significant decrease of complication rate in the study group, and especially for skin complications.

Conclusions

The tested hypothesis was not confirmed: there was no significant change in the calculated blood loss. No bias was identified in complication analysis. The decreased rate of skin complication might be a positive influence of the silicone ring tourniquet.
Literature
1.
Jiang FZ, Zhong HM, Hong YC et al (2015) Use of a tourniquet in total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials. J Orthop Sci 20:110–123CrossRefPubMed
2.
Yi S, Tan J, Chen C et al (2014) The use of pneumatic tourniquet in total knee arthroplasty: a meta-analysis. Arch Orthop Trauma Surg 134:1469–1476CrossRefPubMed
3.
4.
Märdian S, Matziolis G, Schwabe P (2015) Influence of wound drainage in primary total knee arthroplasty without tourniquet. Int Orthop 39:435–440CrossRefPubMed
5.
Parvizi J, Diaz-Ledezma C (2013) Total knee replacement with the use of a tourniquet: more pros than cons. Bone Joint J 95B(11 Suppl A):133–134CrossRef
6.
Tai TW, Chang CW, Lai KA et al (2012) Effects of tourniquet use on blood loss and soft-tissue damage in total knee arthroplasty: a randomized controlled trial. J Bone Joint Surg Am 94A:2209–2215CrossRef
7.
Pfitzner T, von Roth P, Voerkelius N et al (2014) Influence of the tourniquet on tibial cement mantle thickness in primary total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc doi: 10.1007/s00167-014-3341-6
8.
Olivecrona C, Blomfeldt R, Ponzer S et al (2013) Tourniquet cuff pressure and nerve injury in knee arthroplasty in a bloodless field. A neurophysiological study. Acta Orthop 84:159–164CrossRefPubMedPubMedCentral
9.
Heller S, Chen A, Restrepo C et al (2015) Tourniquet release prior to dressing application reduces blistering following total knee arthroplasty. J Arthroplasty 30:1207–1210CrossRefPubMed
10.
Liu D, Graham D, Gillies K et al (2014) Effects of tourniquet use on quadriceps function and pain in total knee arthroplasty. Knee Surg Relat Res 26:207–213CrossRefPubMedPubMedCentral
11.
12.
Chen S, Li J, Peng H et al (2014) The influence of a half-course tourniquet strategy on peri-operative blood loss and early functional recovery in primary total knee arthroplasty. Int Orthop 38:355–359CrossRefPubMed
13.
Drosos GI, Ververidis A, Mavropoulos R et al (2013) The silicone ring tourniquet in orthopaedic operations of the extremities. Surg Technol Int 23:251–257PubMed
14.
Brin YS, Feldman V, Ron Gal I et al (2015) The sterile elastic exsanguination tourniquet vs. the pneumatic tourniquet for total knee arthroplasty. J Arthroplasty 30:595–599CrossRefPubMed
15.
Antoni M, Jenny JY, Noll E (2014) Postoperative pain control by intra-articular local anesthesia versus femoral nerve block following total knee arthroplasty: impact on discharge. Orthop Traumatol Surg Res 100:313–316CrossRefPubMed
16.
Rosencher N, Kerkkamp HEM, Macheras G et al (2003) Orthopedic Surgery Transfusion Hemoglobin European Overview (OSTHEO) study: blood management in elective knee and hip arthroplasty in Europe. Transfusion 43:459–469CrossRefPubMed
17.
Pereira A, Hendriks S, Facca S et al (2015) Evaluation of a new tourniquet for hand surgery: comparison of 76 carpal tunnel syndrome cases operated using a Hemaclear(®) Model-F tourniquet versus a pneumatic tourniquet. Chir Main 34:73–78CrossRefPubMed
18.
Moráis S, Ortega-Andreu M, Rodríguez-Merchán EC et al (2014) Blood transfusion after primary total knee arthroplasty can be significantly minimised through a multimodal blood-loss prevention approach. Int Orthop 38:347–354CrossRefPubMed
19.
Chalidis BE, Kalivas E, Parziali M et al (2012) Cuff width increases the serum biochemical of tourniquet-induced skeletal muscle ischemia in rabbits. Orthopedics 35:e1245–e1250CrossRefPubMed
20.
Mittal P, Shenoy S, Sandhu JS (2008) Effect of different cuff widths on the motor nerve conduction of the median nerve: an experimental study. J Orthop Surg Res 3:1CrossRefPubMedPubMedCentral
21.
Raft J, Millet F, Meistelman C (2015) Example of cost calculations for an operating room and a post-anesthesia care unit. Anesth Crit Care Pain Med doi: 10.1016/j.accpm.2014
22.
Thompson SM, Middleton M, Farook M et al (2011) The effect of sterile versus non-sterile tourniquets on microbiological colonisation in lower limb surgery. Ann R Coll Surg Engl 93:589–590CrossRefPubMedPubMedCentral
Metadata
Title
Silicone ring tourniquet or pneumatic cuff tourniquet for total knee arthroplasty
Authors
Jean-Yves Jenny
David Bahlau
Sandra Wisniewski
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 9/2016
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-016-3160-0

Other articles of this Issue 9/2016

International Orthopaedics 9/2016 Go to the issue

Original Paper

Current data on acute haematogenous osteomyelitis in children in Southern Israel: epidemiology, microbiology, clinics and therapeutic consequences

Original Paper

Accuracy of Low Dose Computed Tomography Scanogram for Measurement of Femoral Version after Locked Intramedullary Nailing

Original Paper

Considerations in performing open surgical excision of dorsal wrist ganglion cysts

Original Paper

Early detection of local recurrence after soft tissue sarcoma resection and flap reconstruction

Original Paper

Long-term results with the Atlas IIIp elastic cementless acetabular component in total hip replacement

Original Paper

Balloon tibioplasty for reduction of depressed tibial plateau fractures: Preliminary radiographic and clinical results