Comparing the Effect of Tourniquet vs Tourniquet-Less in Simultaneous Bilateral Total Knee Arthroplasties

Abstract Background Total knee arthroplasty (TKA) is a commonly performed procedure worldwide for the treatment of knee joint disease. Tourniquet is frequently used during the entire procedure to reduce blood loss and increase surgical comfort. On the other hand, tourniquet-related complications exist, and there are still controversies whether benefits outweigh the risks. Methods Patients undergoing simultaneous TKAs had one knee assigned to group A (use of tourniquet during the entire procedure) and the other knee assigned to group B (use of tourniquet only during cementation). Blood loss, intraoperative complications, implant alignment, soft tissue swelling, pain score, and range of motion were analyzed. Results Fifty-four patients undergoing 108 TKAs were included in the study. Total blood loss was almost 2 times higher in group B knees compared with group A. No difference was observed between groups in implant alignment, soft tissue swelling, pain, range of motion, or other early postoperative complications. Conclusion Tourniquet use in TKAs during the entire surgical procedure reduces total blood loss, without an increase in early postoperative complications.