International Orthopaedics

, Volume 37, Issue 5, pp 827–832 | Cite as

Tourniquet time affects postoperative complications after knee arthroplasty

  • Charlotta Olivecrona
  • Lasse J. Lapidus
  • Lina Benson
  • Richard Blomfeldt
Original Paper



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.


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.


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).


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


Total Knee Arthroplasties Cuff Pressure Unicompartmental Knee Arthroplasties Tourniquet Time Deep Wound Infection 


Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Charlotta Olivecrona
    • 1
    • 3
  • Lasse J. Lapidus
    • 1
  • Lina Benson
    • 2
  • Richard Blomfeldt
    • 1
  1. 1.Section of Orthopedics, Department of Clinical Science and EducationSödersjukhuset Karolinska InstitutetStockholmSweden
  2. 2.Department of Clinical Science and EducationSödersjukhuset Karolinska InstitutetStockholmSweden
  3. 3.Section of OrthopedicsSödersjukhusetStockholmSweden

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