Comparing the effect of tourniquet and tranexamic acid on the tibial cement mantle thickness in total knee arthroplasty.

BACKGROUND This study aims to determine the efficacy of both tranexamic acid (TXA) and tourniquet on the tibial cement mantle thickness in total knee arthroplasty (TKA). METHODS We retrospectively reviewed the recorded data of patients with primary end-stage knee osteoarthritis who underwent TKA procedure during 2014-2016 at a single institution to evaluate the tibial cement mantle. Patients were categorized in two groups based on the use of tourniquet (groups 1 and 2). In addition, these groups were categorized into two different subgroups based on the use of TXA in groups 1 and 2 (group 1-A, B and group 2-A, B). Four zones at the tibial baseplate on the anteroposterior view and two zones on the lateral view were measured at the 4-6-week postoperative visit. RESULTS A total of 28 patients (30 knees) were operated using tourniquet and TXA (group 1-A), 29 (30 knees) using tourniquet without TXA (group 1-B), 24 (28 knees) using TXA without tourniquet (group 2-A), and 38 (42 knees) without using TXA and tourniquet (group 2-B). Although a significant difference was found in the cumulative cement mantle penetration on postoperative X-rays between groups 1 and 2, no significant differences were found between groups A and B in both groups. CONCLUSIONS This study reports that tourniquet use in TKA increased cement mantle penetration of the tibial component in primary TKA. The main strength of this study was that the TXA use alone exhibited no significant effect on the cement thickness.