Abstract
Tourniquet use in total knee arthroplasty has become a controversial topic. There
are several benefits of its use including improved visualization, decreased blood
loss, shorter operative times, and improved antibiotic delivery. Conversely, there
are several significant downsides associated with tourniquet use including postoperative
pain, neuromuscular injuries, wound complications, reperfusion injury, increased risk
of thrombosis, patellar tracking issues, delayed rehabilitation including decreased
postoperative range of motion, and its negative effect on patients with vascular disease.
However, objectively, the literature does not definitively push us toward or away
from the use of a tourniquet. Furthermore, several alternatives have been developed
to help mitigate some of the adverse effects associated with its use. This article
summarizes the evidence for and against tourniquet use and provides an evidence-based
approach to help guide surgeons in their own practice.
Keywords
tourniquet - total knee replacement - total knee arthroplasty - TKA
