止血带使用方式对膝关节单髁置换术后康复的影响

doi:10.20047/j.issn1673-7210.2023.18.19

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Abstract Objective To investigate the effect of tourniquet usage on rehabilitation after unicompartmental knee arthroplasty. Methods A retrospective analysis was performed on 100 patients who received unicondylar replacement of knee joint in the Department of Joint Surgery, the Affiliated Hospital of Xuzhou Medical University from January to December 2021. According to the way of tourniquet application, the patients were divided into the whole course group of 33 cases, the second half group of 34 cases, and the non-tourniquet group of 33 cases. Operation time, blood loss, hemoglobin (Hb) and erythrocyte volume (Ht), thromboelasticity chart, visual analog scale (VAS) score, swelling rate of affected limb, American hospital for special surgery (HSS) score of knee joint and postoperative complications were recorded in the three groups. Results The swelling rate of the whole course group was higher than that of the second half group and non-tourniquet group (P＜0.05). At 24 h after surgery, Hb and Ht in the three groups were lower than before surgery, and the whole course group was higher than the second half of the course group and non- tourniquet group (P＜0.05). The VAS score of the whole course group was higher than that of the second half group and non-tourniquet group, the total blood loss and intraoperative blood loss were less than those of the second half group and non-tourniquet group, and the recessive blood loss was more than those of the second half group and non-tourniquet group (P＜0.05). The operation time of the whole course group and the second half group was shorter than that of the group without tourniquet (P＜0.05). The overall analysis showed that there were significant differences between groups and time points in HSS evaluation (P＜0.05). Further pairwise comparison and intra-group comparison: HSS scores of the three groups were compared at each time point, and the differences were statistically significant (P＜0.05). Comparison between groups: HSS score one month after operation in the whole course group was lower than that in the second half group and non-tourniquet group (P＜0.05). The overall analysis showed that there were significant differences among MA groups in comparison, time point comparison and interaction (P＜0.05). For further pairwise comparison, intra-group comparison showed that the MA of the whole group before surgery was lower than one day after surgery, and that of the whole group one day after surgery was higher than before surgery and seven days after surgery (P＜0.05). Comparison between groups: MA of the whole course group at seven days after surgery was higher than that of the second half group and non-tourniquet group (P＜0.05). There was no significant difference in the incidence of complications one month after operation among the three groups (P＞0.05). Conclusion The use of a tourniquet from the completion of osteotomy to the completion of suturing during unicompartmental knee replacement helps to reduce the effect on coagulation status, reduce postoperative pain and the degree of swelling of the affected limb, shorten the operative time, and promote functional recovery.

Key words： Tourniquet Unicompartmental knee arthroplasty Recessive blood loss Complications

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	GU Xu1 SUN Shaosong2 SHI Sifeng2 ZHENG Xin2 LU Renxiang1 CAO Jie1 LI Hongwei2

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GU Xu1 SUN Shaosong2 SHI Sifeng2 ZHENG Xin2 LU Renxiang1 CAO Jie1 LI Hongwei2. Effect of tourniquet usage on rehabilitation after unicompartmental knee arthroplasty[J]. 中国医药导报, 2023, 20(18): 87-91.

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https://www.yiyaodaobao.com.cn/EN/10.20047/j.issn1673-7210.2023.18.19 OR https://www.yiyaodaobao.com.cn/EN/Y2023/V20/I18/87

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