Comparative study between thromboembolism and total knee arthroplasty with or without tourniquet in rheumatoid arthritis patients

• Published in: Archives of orthopaedic and trauma surgery Vol. 122; no. 8; pp. 442 - 446
• Main Authors: WAUKE, Koichi, NAGASHIMA, Masakazu, KATO, Nobuya, OGAWA, Ryo, YOSHINO, Shinichi
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01-11-2002; Springer Nature B.V
• Subjects: Arthritis, Rheumatoid - surgery; Arthroplasty, Replacement, Knee - methods; Biological and medical sciences; Blood Loss, Surgical; Female; Humans; Joint surgery; Medical sciences; Orthopedic surgery; Postoperative Complications - etiology; Pulmonary embolisms; Rheumatoid arthritis; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Thromboembolism - etiology; Tourniquets - adverse effects; Venous Thrombosis - etiology; Knee; Prosthesis; Diseases of the osteoarticular system; Cardiovascular disease; Autoimmune disease; Inflammatory joint disease; Venous disease; Vascular disease; Complication; Thromboembolism; Technical equipment; Tourniquet; Human; Postoperative; Immunopathology; Total knee arthroplasty; Respiratory disease; Deep vein thrombosis; Pulmonary embolism; Chronic; Orthopedic surgery; Treatment; Rheumatoid arthritis; Total; Technique; Comparative study
• ISSN: 0936-8051; 1434-3916
• DOI: 10.1007/s00402-002-0404-9

To investigate whether the occurrence of pulmonary embolism (PE) and/or deep vein thrombosis (DVT) are influenced by use of a tourniquet or not in the patients who underwent total knee arthroplasty for rheumatoid arthritis (RA).
The patients were randomly divided into a with-tourniquet group (19 patients) and a without-tourniquet group (18 patients). In the first group, snowstorm-like echogenic particles were observed after deflation of the tourniquet in all patients according to the transesophageal echocardiography.
In addition, the PaO(2) level was significantly decreased. Also, one had a PE, and DVT was confirmed in two patients. In the without-tourniquet group, none of these conditions was noted.
These results suggest that the use of a tourniquet will promote the risk of developing postoperative PE and/or DVT after total knee arthroplasty.