Use of a pneumatic tourniquet in total knee arthroplasty increases the risk of distal deep vein thrombosis: A prospective, randomized study

Background: There has been controversy regarding the incidence of deep vein thrombosis (DVT) after total knee arthroplasty (TKA) with or without the use of a tourniquet. The aim of this randomized, prospective study was to clarify the effects of tourniquet use on DVT in TKA. Methods: The subjects were 109 patients scheduled to undergo TKA from April 2008 to March 2009 before the establishment of the American Association of Orthopedic Surgeons (AAOS) practice guidelines. They were randomized into two groups: 51 patients in the tourniquet group (group T) and 52 patients in the control group without a tourniquet (group C). We investigated the thrombotic presence using ultrasonography one week after surgery and compared both groups. Results: There was no difference in the rate of proximal DVTs (P = 0.63). However, the risk of distal DVT was significantly higher in group T than in group C (52.9% vs. 23.1%; P = 0.002). Conclusions: Use of the tourniquet in TKA increased the risk of distal DVT. (C) 2016 Elsevier B.V. All rights reserved.