To reduce blood loss in total knee arthroplasty various physical measures including the use of a tourniquet are recommended. The question of an early tourniquet release is still unsettled.
To confirm our theory that blood loss and need of blood transfusions might be reduced while removing the tourniquet for meticulous hemostasis before wound closure we analysed 70 (41 male, 29 female) consecutive patients with total knee arthroplasty for osteoarthritis performed by a single surgeon in a prospective-randomized study between 1/1996 to 6/1998. In group I the tourniquet was released before, in group II after wound closure.
We couldn't find any significant differences in the estimated blood loss, the decrease of hemoglobin and hematocrit level, and the transfusion need. In Group II we observed two cases of deep vein thrombosis. This difference was not significant.
We conclude that tourniquet release for hemostasis is not an effective tool in reducing blood loss or transfusion need in total knee arthroplasty.