Comparison of Tourniquet and Non-Tourniquet Use in Total Knee Arthroplasty: Impact on Postoperative Hemoglobin Changes and Surgical Time

Aim: This study aimed to evaluate the impact of pneumatic tourniquet use on postoperative hemoglobin (Hb) and hematocrit (Hct) levels, changes in Hb/Hct, and surgery duration in total knee arthroplasty (TKA) by comparing outcomes between patients who underwent the procedure with and without tourniquet application. Material and Method: A retrospective cohort study was conducted on 130 patients with Kellgren-Lawrence grade 3-4 gonarthrosis who underwent TKA. Patients were divided into two groups, each with 65 patients, based on tourniquet use. Preoperative and postoperative day 1 Hb/Hct values, ΔHb/ΔHct, and surgery duration were compared. Patients with comorbidities and significant perioperative complications were excluded. Results: No significant differences were found between the tourniquet and non-tourniquet groups for preoperative or postoperative Hb and Hct levels (p>0.05). Both groups experienced significant reductions in hemoglobin and hematocrit levels postoperatively. The non-tourniquet group had a slightly greater decrease in hemoglobin and hematocrit, although this difference was not statistically significant (p>0.05). The tourniquet group demonstrated a significantly shorter operation duration (p=0.004). Conclusion: Tourniquet use in TKA reduces surgical time without significantly affecting blood loss. The comparable outcomes in both groups suggest that the use of a tourniquet may offer practical advantages, in terms of procedural efficiency in reducing surgical time, but its influence on postoperative Hb and Hct changes is minimal.