Study finds, Outcomes of Tourniquet-Less Revision Total Knee
A tourniquet is routinely used in total knee arthroplasty (TKA) to limit perioperative blood loss and increase the visibility of the surgeon's field of view. This study aims to evaluate the postoperative clinical outcomes and complications associated with tourniquet use in revision TKA.

Researchers conducted a retrospective review of 1,904 consecutive patients who underwent revision TKA. Propensity score–based matching was done to adjust for baseline differences in patient demographics and procedure details.

--Propensity score matching resulted in a cohort of 548 revision total joint arthroplasty patients, 274 of whom were tourniquet patients matched to 274 tourniquet-less patients.

--Multivariate regression analyses demonstrated that, compared with the tourniquet-less cohort, the tourniquet cohort had significantly less intraoperative (413.7 to 353.2 mL) and total perioperative (1,548.7 to 1,417.8 mL) blood loss.

--However, no significant differences were present in total perioperative (8.4%, 6.6%) transfusion rates.

--The tourniquet cohort had increased length of stay (3.2 to 3.7 days) and 30-day readmissions.

Although removing the tourniquet in revision TKA results in significantly higher perioperative blood loss, no significant changes in perioperative transfusion rates were found in this study. In addition, revision TKA without the use of a tourniquet was linked to a shorter postoperative stay, fewer 30-day readmissions, and a greater range of flexion.