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The timing of tourniquet release and its influence on blood loss after total knee arthroplasty

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We performed a prospective, randomized study on 76 patients (82 knees) scheduled for total knee arthroplasty to determine the effect of tourniquet release and hemostasis on the peri- and postoperative blood loss. Patients were randomly divided in two groups. Posterior cruciate retaining tricompartmental total knee prostheses were used in all. In group 1, the tourniquet was deflated intraoperatively after the prosthetic components were settled and hemostasis was done. In group 2, the tourniquet was released after the wound was closed and a compressive bandage was applied. Mean blood drainage was 880.85 ml (320–1,315) in group 1 and 745.36 ml (220–1,175) in group 2 (p=0.03). The mean number of blood transfusions given, hemoglobin and hematocrit values, operation time, and tourniquet time were similar in both groups. Intraoperative tourniquet release and hemostasis does not reduce total blood loss in total knee arthroplasty.


Nous avons exécuté une étude prospective et randomisée sur 76 malades (82 genoux) programmé pour arthroplastie du genou total pour déterminer l’effet de la levée de garrot- hémostase sur le perte de sang per—et postopératoire. Une prothèse tricompartmentale du genou, avec conservation du croisé postérieur totale a été utilisée dans tous les cas. Les malades étaient randomisés et divisés en deux groupes. Dans le groupe 1 le garrot a été dégonflé en intraopératoire après que les composants prothétiques aient été posés et l’hémostase a, alors été faite. Dans le groupe 2 le garrot a été retiré après la fermeture et la mise en place d’un pansement compressif. La perte moyenne de sang par drainage était 880.85 ml (320–1315) dans le groupe 1 et 745.36 ml (220–1175) dans le groupe 2 (p=0.03). Le nombre moyen de transfusions du sang effectuées, les valeurs de l’hémoglobine et de l’hématocrite, la durée opératoire et la durée du garrot étaient semblables dans les deux groupes.La levée du garrot pendant l’opération avec hémostase ne réduit pas la perte totale du sang dans l’arthroplastie du genou.

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Correspondence to Murat Ali Hersekli.

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Hersekli, M.A., Akpinar, S., Ozkoc, G. et al. The timing of tourniquet release and its influence on blood loss after total knee arthroplasty. International Orthopaedics (SICOT) 28, 138–141 (2004).

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