Use of a tourniquet is not associated with increased risk of venous thromboembolism after fast-track total knee arthroplasty: a prospective multicenter cohort study of 16,250 procedures
| Title: | Use of a tourniquet is not associated with increased risk of venous thromboembolism after fast-track total knee arthroplasty: a prospective multicenter cohort study of 16,250 procedures |
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| Authors: | Pelle Baggesgaard Petersen, Mette Mikkelsen, Christoffer Calov Jørgensen, Andreas Kappel, Anders Troelsen, Henrik Kehlet, Kirill Gromov |
| Source: | Acta Orthopaedica, Vol 94 (2023) |
| Publisher Information: | Medical Journals Sweden, 2023. |
| Publication Year: | 2023 |
| Collection: | LCC:Orthopedic surgery |
| Subject Terms: | Arthroplasty, fast-track, Knee, tourniquet, Orthopedic surgery, RD701-811 |
| More Details: | Background and purpose: Venous thromboembolism (VTE) is a serious postoperative complication after total knee arthroplasty (TKA). Use of a tourniquet has shown conflicting results for risk of VTE after TKA. We aimed to investigate the associated risk of VTE after TKA using tourniquet in a fast-track set-up as no previous data exists. Patients and methods: We performed an observational cohort study from 9 fast-track centers including unilateral primary TKA from 2010–2017 with prospective collection of preoperative risk-factors and complete 90-day follow-up. Use of a tourniquet was registered in the Danish Knee Arthroplasty Register. Postoperative VTE was identified from health records. We performed risk analyses using a mixed-effects logistic regression model adjusting for previously identified risk factors. Results: Of the 16,250 procedures (39% males, mean age 67.9 [SD 10.0] years, median LOS 2 [interquartile range 2–3]) 12,518 (77%) were performed with a tourniquet. The annual tourniquet usage varied greatly between departments from 0% to 100%, but also within departments from 0% to 99%. There was no significant difference between the 2 groups with 52 (0.42%) VTEs in the tourniquet group vs. 25 (0.67%) in the no-tourniquet group (p = 0.06 for cumulative 90-day incidence of VTE). This association remained statistically insignificant for VTE using tourniquet after adjustment for previously identified risk factors. Conclusion: We found no association between the use of a tourniquet and increased risk of 90-day VTE after primary fast-track TKA, irrespective of the length of time for which the tourniquet was applied. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 17453674 1745-3674 1745-3682 |
| Relation: | https://actaorthop.org/actao/article/view/13793; https://doaj.org/toc/1745-3674; https://doaj.org/toc/1745-3682 |
| DOI: | 10.2340/17453674.2023.13793 |
| Access URL: | https://doaj.org/article/64ee986e4c6444a2a762a1fed9fd684b |
| Accession Number: | edsdoj.64ee986e4c6444a2a762a1fed9fd684b |
| Database: | Directory of Open Access Journals |
| ISSN: | 17453674 17453682 |
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| DOI: | 10.2340/17453674.2023.13793 |
| Published in: | Acta Orthopaedica |
| Language: | English |