抄録
Deep vein thrombosis and pulmonary embolism remain among the most severe complications after total knee arthroplasty (TKA) despite the various methods taken to prevent them. TKA without a tourniquet is one of the preventive methods. In this study, we investigated the volume of blood loss in TKA without a tourniquet in 30 cases treated by TKA from May 2003 to July 2004. The patients were 5 men and 25 women, with an average age of 74 years (range, 62 to 84 years). Seventeen of the patients had hypertension (HT). Preoperative autologous donation was 800 ml by each patient, and cell saver was used during surgery. Total actual blood loss was the sum of blood loss during and after surgery. The estimated blood loss was calculated from change of hemoglobin (Hb).
None of the cases were complicated by pulmonary embolism during the follow-up period of 4-19 months (mean 10.5 months). Average actual blood loss was 1,409 ml, and the mean estimated blood loss was 1,725 ml. There was no significant correlation between the two volumes. There was no significant correlation in the volume of blood loss between with and without hypertension. None of the patients required transfusion in excess of their autologous donation. We thought that TKA without a tourniquet might be a useful method in terms of prevention of pulmonary embolism, but it is important to reduce total blood loss during surgery.
