No difference in reoperation rates or aseptic loosening following cemented total knee arthroplasty with or without a tourniquet

Introduction

The objective of the current study was to evaluate the reoperation rate among patients undergoing cemented total knee arthroplasty (TKA) with or without an intraoperative tourniquet.

Materials and methods

A retrospective cohort study of consecutive patients who received a primary, cemented TKA at a high volume academic orthopaedic center. Eligible patients underwent primary, cemented TKA either with or without the use of a tourniquet throughout the entirety of the care. The causes and timing of reoperations were recorded. Survivorship analysis was conducted using Kaplan-Meier curves. Cox proportional hazards models were utilized to evaluate independent predictors of reoperation.

Results

There were 2276 (58%) cases in which a tourniquet was used and 1663 (42%) cases with no tourniquet use. Mean time from the primary TKA was 14.7 years. The cumulative survival at final follow-up for the no tourniquet group and tourniquet group were 92.2% and 96.5%, respectively. Only younger age was an independent predictor of both all cause revision and aseptic loosening.

Conclusions

Adjusting for confounders, the presence of a tourniquet did not affect the rates of long-term all-cause revision rates or aseptic loosening. Younger patients have a higher risk of all-cause reoperation and reoperation due to aseptic loosening.

Level of evidence

Level III.