The use of tourniquet during total knee replacement in patients with and without popliteal artery calcification

Vivacqua, Thiago; Barroso, Murilo; Matos, Pedro; Albuquerque, Rodrigo Pires e; Cavanellas, Naasson; Barretto, João Maurício

doi:10.1016/j.rboe.2016.12.014

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Revista Brasileira de Ortopedia

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Artigos Originais • Rev. bras. ortop. 53 (2) • Mar-Apr 2018 • https://doi.org/10.1016/j.rboe.2016.12.014 copy

The use of tourniquet during total knee replacement in patients with and without popliteal artery calcification^☆ ☆ Study conducted at Instituto Nacional de Traumatologia e Ortopedia, Centro de Cirurgia do Joelho, Rio de Janeiro, RJ, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

Identify the clinical and surgical complications associated with the use of a tourniquet in total knee arthroplasty in patients with or without calcification of the popliteal artery.

Methods:

The study was performed retrospectively, analyzing 58 patients with calcification of the popliteal artery and 57 patients as a control group.

Results:

The case group patients were significantly older than patients in the control group; however, this had no impact on the clinical outcome in the analyzed period.There were no complications during surgery in the groups studied, as there were no statistically significant differences between the incidence of local or systemic intercurrences in the analyzed period.

Conclusion:

This study found low rates of complications in patients undergoing total knee arthroplasties with use of a tourniquet, with or without calcification of the popliteal artery.

Keywords:
Arthroplasty replacement knee; Postoperative complications; Tourniquets; Popliteal artery

Complication	Incidence			p-Value of the test χ²	Odds ratio (OR)	OR confidence interval	Power of the test (%)
	Control group	Case group	Global
Deep venous thrombosis (gastrocnemius vein) (%)	1	3	4	0.364^a a Without statistical significance, p > 0.05.	3.17	0.32-31.43	82.08
Deep venous thrombosis (gastrocnemius vein) (%)	1.8	5.4	3.5
Pulmonary thromboembolism (%)	0	1	1	0.496^a a Without statistical significance, p > 0.05.	-	-	-
Pulmonary thromboembolism (%)	0.0	1.8	0.9
Acute arterial occlusion (%)	0	0	0	1.000	-	-	-
Acute arterial occlusion (%)	0	0	0
Surgical wound complication
Skin necrosis (%)	6	5	11	0.579	-	-	8.59
Skin necrosis (%)	10.5	8.9	9.7
Cellulitis (%)	0	1	1				-
Cellulitis (%)	0	1.8	0.9
Varied complications (overall) (%)	6	8	14	0.544	1.417	0.46-4.39	25.59
Varied complications (overall) (%)	10.53	14.29	12.39
Acute (superficial) infection (%)	1	0	1	1.000^a a Without statistical significance, p > 0.05.	-	-	-
Acute (superficial) infection (%)	1.8	0.0	0.9
Anemia (%)	0	1	1	0.496^a a Without statistical significance, p > 0.05.	-	-	-
Anemia (%)	0.0	1.8	0.9
Thigh ecchymosis/thrombocytopenia (%)	1	0	1	1.000^a a Without statistical significance, p > 0.05.	-	-	-
Thigh ecchymosis/thrombocytopenia (%)	1.8	0.0	0.9
Hyperkalemia (%)	0	1	1	0.496^a a Without statistical significance, p > 0.05.	-	-	-
Hyperkalemia (%)	0.0	1.8	0.9
Hypokalemia (%)	1	1	2	1.000^a a Without statistical significance, p > 0.05.	1.02	0.06-16.69	5.0
Hypokalemia (%)	1.8	1.8	1.8
AMI (%)	0	1	1	0.496^a a Without statistical significance, p > 0.05.	-	-	-
AMI (%)	0.0	1.8	0.9
Urinary tract infection (%)	0	1	1	0.496^a a Without statistical significance, p > 0.05.	-	-	-
Urinary tract infection (%)	0.0	1.8	0.9
UTI/disorientation (%)	0	1	1	0.496^a a Without statistical significance, p > 0.05.	-	-	-
UTI/disorientation (%)	0.0	1.8	0.9
Fibular neuropathy (%)	1	0	1	1.000^a a Without statistical significance, p > 0.05.	-	-	-
Fibular neuropathy (%)	1.8	0.0	0.9
Thrombocytopenia (%)	0	2	2	0.125^a a Without statistical significance, p > 0.05.	-	-	-
Thrombocytopenia (%)	0.0	3.6	3.6
Anaphylactic reaction (%)	1	0	1	1.000^a a Without statistical significance, p > 0.05.	-	-	-
Anaphylactic reaction (%)	1.8	0.0	0.9
Joint stiffness (%)	1	0	1	1.000^a a Without statistical significance, p > 0.05.	-	-	-
Joint stiffness (%)	1.8	0.0	0.9
Late surgical wound secretion (%)	1	0	1	1.000^a a Without statistical significance, p > 0.05.	-	-	-
Late surgical wound secretion (%)	1.8	0.0	0.9

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] *Corresponding author. E-mail: drthiagovivacqua@gmail.com (T. Vivacqua).

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The use of tourniquet during total knee replacement in patients with and without popliteal artery calcification☆ ☆ Study conducted at Instituto Nacional de Traumatologia e Ortopedia, Centro de Cirurgia do Joelho, Rio de Janeiro, RJ, Brazil.

ABSTRACT

Objective:

Methods:

Results:

Conclusion:

The use of tourniquet during total knee replacement in patients with and without popliteal artery calcification^☆ ☆ Study conducted at Instituto Nacional de Traumatologia e Ortopedia, Centro de Cirurgia do Joelho, Rio de Janeiro, RJ, Brazil.