The relationship of lateral release and tourniquet deflation in total knee arthroplasty

One hundred seventy-one knees (133 patients) were prospectively evaluated for need of LRR before and after tourniquet deflation. Tourniquet inflation in flexion versus extension was assessed in a subset group (72 knees). The need for LRR was determined using the rules of “no-thumbs” and “full contact.” Before deflation, 77 knees appeared to need LRR, and after deflation, 27 knees required LRR, representing a 65% reduction. There was no difference between flexion/extension groups. Often, the surgeon evaluates patellar tracking with the tourniquet inflated, not considering the effect of tourniquet pressure on the quadriceps muscle. If tracking is questionable with the tourniquet inflated, reassess after deflation before considering LRR.