Effect of tourniquet release timing on perioperative blood loss in cemented total knee arthroplasty

Objective To study the effect of tourniquet release timing on perioperative blood loss in cemented total knee arthroplasty (TKA) .Methods From June 2006 to June 2008,80 TKA patients were randomly allocated into 2 equal groups.In Group A,the tourniquet was released and haemostasis secured before wound closure.In group B,the tourniquet was released after skin closure and compressive bandaging.Results We found a significant difference between the 2 groups in intraoperative (Group A:161.5±50.1 mL＞Group B:70.0±19.4 mL),postoperative (Group A:357.8±104.7 mL＜group B:467.9±116.0 mL)and total (Group A:516.8±107.9 mL＜Group B:579.5±140.2 mL)blood loss (P＜0.05) .But no significant difference was found in blood transfusion,operation time or tourniquet time (P＞0.05).In knee flexion,Group A was better than Group B before 2 weeks,but the two were not significantly different after 8 weeks and nearly the same 6 months.Conclusion We recommend tourniquet release and haemostssis before wound closure,as it can reduce total blood loss and avoid possible risks of extended tourniquet. Key words: Postoperative hemorrhage;  Arthroplasty,replacement,knee;  Tourniquets