Effect of Tourniquet Pressure on Perioperative Blood Loss Associated With Cementless Total Knee Arthroplasty: A Prospective, Randomized Study

Perioperative blood loss is an issue of concern in cementless total knee arthroplasty (TKA). We randomly assigned 57 patients (60 knees) who underwent cementless TKA treatment to 2 groups with tourniquet pressure (TP) of either 350 mm Hg (30 knees) or systolic blood pressure (SBP) plus 100 mm Hg (30 knees) to assess the effect of TP on blood loss. The mean TP in the SBP plus 100 mm Hg group was 238 ± 13 mm Hg. There was no significant difference between groups. Red blood cell count, hemoglobin levels, and hematocrit recovered to preoperative levels by 3 months after surgery in both groups. In conclusion, we recommend using a TP of 100 mm Hg above SBP during TKA, rather than using the conventional TP of 350 mm Hg.