Effect of Tourniquet on Risk of Early Infection after Total Knee Arthroplasty.

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概要

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• Objective: Postoperative infection is one of the most difficult-to-treat complications after total knee arthroplasty (TKA) . Various measures are taken to prevent it, but none is effective enough, and the prognosis in infection after TKA is generally poor. In the present study, we evaluated the effects of the use of a tourniquet on the onset of early postoperative infection.<BR>Methods: Findings obtained from patients who underwent primary TKA in this facility between April 1988 and September 1999 using a tourniquet (tourniquet group; 159 joints) were compared to those obtained from patients who underwent primary TKA between October 1999 and March 2001 without using a tourniquet (non-tourniquet group; 92 joints) . Follow-up observations were conducted for 2 to 20 months in both groups.<BR>Results: The total volume of bleeding was obviously greater in the non-tourniquet group (803.5±433.0 ml) than in the tourniquet group (458.2 ±326.8ml) . Postoperative infection occurred in 3 patients in the tourniquet group, but none in the non-tourniquet group.<BR>Conclusions: Hypoxia in the wounded areas caused by the use of a tourniquet results in the suppression of vascularization and fibroblast activity and a reduction in macrophage activity. This is expected to result in a delay in wound healing and the impairment of the infection defense system. The non-use of a tourniquet may contribute to the prevention of early postoperative infection.

• 日本関節病学会の論文

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