AVALIAÇÃO DO SANGRAMENTO PERI-OPERATÓRIO NA ARTROPLASTIA TOTAL DO JOELHO COM E SEM O USO DO GARROTE

INTRODUCTION: Introduction: The use of a tourniquet in total knee arthroplasty (TKA) surgery is a common practice believed to enhance operative field visibility, reduce intraoperative blood loss, and improve cementation quality. However, recent meta-analyses have shown that tourniquet use is associated with a higher risk of severe adverse events, postoperative pain, prolonged hospital stays, and increased occult bleeding.The only benefit reported in favor of the use of a tourniquet appears to be the reduction of surgical time. AIMS: Objectives: study aims to analyze whether there was a significant reduction in serum levels of hemoglobin(Hb) and hematocrit(Ht) in the postoperative period in patients undergoing total knee arthroplasty (TKA) without tourniquet usage, compared to patients operated on with tourniquet usage. Secondary objectives include investigating potential blood transfusion requirements and surgical time. MATERIALS AND METHODS: Materials and Methods: We conducted a retrospective observational study, analyzing the medical records of patients who underwent total knee arthroplasty between july 2017 and october 2022 at the same hospital, with surgeries performed by the same surgical team. Patients were divided into two groups based on the use or non-use of a tourniquet during surgery. RESULTS: Results: The use of a tourniquet did not reduce blood loss in patients undergoing total knee arthroplasty (TKA). After 48 hours, there were no statistically significant differences in hemoglobin (Hb) and hematocrit (Ht) levels between the groups with and without tourniquet use. FINAL CONSIDERATIONS: Conclusion: The use of a tourniquet in total knee arthroplasty surgeries without significant changes in Hb and Ht levels at 48 hours after the surgery. Additionally, no significant differences were observed in surgical time between the two groups.

KEYWORDS: Arthroplasty; Knee; Hemorrhage; Tourniquet