Commentary

The study by Tetro and Rudan does not support the use of a tourniquet in cemented total knee arthroplasty. When the tourniquet and non-tourniquet groups were compared, there was no difference in blood loss or transfusion requirements between them. Operating times did not differ, and the senior surgeon believed that the bone surfaces were adequate in both groups. The authors suggest that the risks associated with tourniquet use (embolic events, venous thrombosis, altered wound-healing, vascular compromise, increased swelling, and neurologic and muscular damage) outweigh the benefits of tourniquet use (reduced blood loss, improved surgical visualization, a potentially shorter operative time, and cleaner, drier bone surfaces) in cemented total knee arthroplasty.