Background
Whether the arterial tourniquet in total knee arthroplasty (TKA) is a friend or a foe is still debated.
Longer ischemia causes hypoxic damage; yet short duration of a tourniquet may influence outcome. Understanding the time-dependent influence of the tourniquet in TKA patients could improve the overall outcome and safety. The purpose of the study was to measure the tourniquet-induced time-dependent alterations in skeletal muscle metabolism in TKA to establish a ‘safe tourniquet time.’