University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Orthopaedic Surgery


Dr. Nancy E. Reid, MHA, DHSc, PA-C, DFAAPA


A total knee arthroplasty (TKA) is performed for a patient with significant arthritis in the knee due to disease or caused by trauma. The prosthesis replaces the joint. Typically, patients are treated conservatively. If conservative management fails and the patient's quality of life decreases, then the surgical procedure is performed. During a TKA, tourniquets are regularly used. The tourniquet is placed on the operative side at the upper thigh. A thigh tourniquet has been used for a TKA for many decades, and it has been reported to improve visualization in the surgical field and decrease postoperative blood loss. Although tourniquet use during a TKA may be helpful in some instances, it may also cause complications. Blood loss during and immediately after TKA is among the most thought-provoking concerns. It has been established that tranexamic acid (TXA) can help minimize perioperative blood loss. TXA can be administered orally, topically, or as an intravenous injection. Additionally, several studies focus on parameters like blood loss and operative time. This review article will also focus on the postoperative pain outcomes without and with tourniquet use to find a recommendation for future application in TKA. Recent articles have found that tourniquet use provides no advantages. Systematic review articles have found that tourniquet use in TKA has caused increased postoperative pain and blood loss. Based on current evidence, more investigations are needed to study the efficacy and benefits of tourniquet use in TKA. This review article aims to compare the blood loss and postoperative pain with and without a tourniquet for a TKA.


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