Tourniquet cuff pressure and nerve injury in knee arthroplasty in a bloodless field
DOI:
https://doi.org/10.3109/17453674.2013.782525Abstract
Background and purpose Tourniquet-related nerve injuries remain a concern in orthopedic surgery. The cuff pressures used today are generally lower, and therefore a decreasing incidence of peripheral nerve injuries might also be expected. However, there have been few neurophysiological studies describing the outcome after bloodless field surgery. We describe the results of neurophysiological examinations and report the incidence of nerve injuries after total knee arthroplasty (TKA) in a bloodless field.Patients and methods This study was part of a prospective, randomized controlled clinical trial in patients scheduled for TKA in a bloodless field. 20 consecutive patients were enrolled. Electroneurography (ENeG) and quantitative sensory testing (QST) of thermal thresholds were performed on day 3. These tests were repeated 2 months after surgery when electromyography (EMG) with a concentric-needle electrode was also performed.Results The mean tourniquet cuff pressure was 237 (SD 33) mmHg. Electromyographic signs of denervation were found in 1 patient, who also had the highest cuff pressure in the study population (294 mmHg). The sensory nerve response amplitudes were lower in the operated leg on day 3; otherwise, the neurophysiological examinations showed no differences between the legs.Interpretation When low tourniquet cuff pressures are used the risk of nerve injury is minor.Downloads
Download data is not yet available.
Downloads
Published
2013-01-01
How to Cite
Olivecrona, C., Blomfeldt, R., Ponzer, S., Stanford, B. R., & Nilsson, B. Y. (2013). Tourniquet cuff pressure and nerve injury in knee arthroplasty in a bloodless field. Acta Orthopaedica, 84(2), 159–164. https://doi.org/10.3109/17453674.2013.782525
Issue
Section
Articles
License
This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License.
Acta Orthopaedica (Scandinavica) content is available freely online as from volume 1, 1930. The journal owner owns the copyright for all material published until volume 80, 2009. As of June 2009, the journal has however been published fully Open Access, meaning the authors retain copyright to their work. As of June 2009, articles have been published under CC-BY-NC or CC-BY licenses, unless otherwise specified.