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J Knee Surg 2021; 34(10): 1057-1063
DOI: 10.1055/s-0040-1701454
Original Article

The Effects of Tourniquet Application in Total Knee Arthroplasty on the Recovery of Thigh Muscle Strength and Clinical Outcomes

Omer Ayik
1   Department of Orthopaedics and Traumatology, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey
,
Mehmet Demirel
1   Department of Orthopaedics and Traumatology, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey
,
Fevzi Birisik
2   Department of Orthopaedics Surgery and Traumatology, University of Health Sciences, Faculty of Medicine, Istanbul Training and Research Hospital, Istanbul, Turkey
,
Ali Ersen
1   Department of Orthopaedics and Traumatology, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey
,
Halil I. Balci
1   Department of Orthopaedics and Traumatology, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey
,
Turker Sahinkaya
3   Department of Sports Medicine, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
,
Sefa Giray Batibay
4   Department of Orthopaedics Surgery and Traumatology, University of Health Sciences, Faculty of Medicine, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
,
Irfan Ozturk
1   Department of Orthopaedics and Traumatology, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey
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Abstract

The present randomized controlled study aims to evaluate whether tourniquet application during total knee arthroplasty (TKA) has an effect on (1) thigh muscle strength (quadriceps and hamstring muscle strength) and (2) clinical outcomes (postoperative knee range of motion [ROM], postoperative pain level, and Knee Society Score [KSS]). The effects of tourniquet application during TKA were investigated in 65 patients randomly allocated to one of two groups: TKA with a tourniquet and TKA without a tourniquet. Patients in both groups were comparable in terms of the demographic and clinical data (p > 0.05 for age, number of patients, sex, radiographic gonarthrosis grade, American Society of Anesthesiologists [ASA] classification, and body mass index [BMI]). All patients in both groups were operated by the same surgeon using one type of prosthesis. Isokinetic muscle strength (peak torque and total work) of knee extensors (quadriceps) and flexors (hamstrings) was measured in Newton meters (Nm) using a CYBEX 350 isokinetic dynamometer (HUMAC/CYBEX 2009, Stoughton, MA). The combined KSS (knee score + function score), visual analog scale (VAS), and knee ROM were measured preoperatively and at 1 and 3 months postoperatively to evaluate clinical outcomes. There were no significant differences between the two groups in preoperative and postoperative values of isokinetic muscle strength (peak torque and total work) and aforementioned clinical outcomes (p < 0.05). The present study has shown that quadriceps strength and clinical outcomes were not improved in the early postoperative period (3 months) when a tourniquet was not used during TKA.

Keywords

tourniquet - total knee arthroplasty - quadriceps strength - isometric muscle strength - knee function - clinical outcomes


Publication History

Received: 04 June 2019

Accepted: 13 December 2019

Article published online:
19 February 2020

© 2020. Thieme. All rights reserved.

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