Use of a tourniquet is not associated with increased risk of venous thromboembolism after fast-track total knee arthroplasty: a prospective multicenter cohort study of 16,250 procedures
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Use of a tourniquet is not associated with increased risk of venous thromboembolism after fast-track total knee arthroplasty : a prospective multicenter cohort study of 16,250 procedures. / Petersen, Pelle Baggesgaard; Mikkelsen, Mette; Jørgensen, Christoffer Calov; Kappel, Andreas; Troelsen, Anders; Kehlet, Henrik; Gromov, Kirill; Madsen, Frank; B Hansen, Torben; Laursen, Mogens; Varnum, Claus; Andersen, Mikkel Rathsach; Krarup, Niels Harry; Palm, Henrik.
In: Acta Orthopaedica, Vol. 94, 2023, p. 342-347.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Use of a tourniquet is not associated with increased risk of venous thromboembolism after fast-track total knee arthroplasty
T2 - a prospective multicenter cohort study of 16,250 procedures
AU - Petersen, Pelle Baggesgaard
AU - Mikkelsen, Mette
AU - Jørgensen, Christoffer Calov
AU - Kappel, Andreas
AU - Troelsen, Anders
AU - Kehlet, Henrik
AU - Gromov, Kirill
AU - Madsen, Frank
AU - B Hansen, Torben
AU - Laursen, Mogens
AU - Varnum, Claus
AU - Andersen, Mikkel Rathsach
AU - Krarup, Niels Harry
AU - Palm, Henrik
N1 - Publisher Copyright: © 2023 The Author(s).
PY - 2023
Y1 - 2023
N2 - Background and purpose — Venous thromboembolism (VTE) is a serious postoperative complication after total knee arthroplasty (TKA). Use of a tourniquet has shown conflicting results for risk of VTE after TKA. We aimed to investigate the associated risk of VTE after TKA using tourniquet in a fast-track set-up as no previous data exists. Patients and methods — We performed an observational cohort study from 9 fast-track centers including unilateral primary TKA from 2010–2017 with prospective collection of preoperative risk-factors and complete 90-day follow-up. Use of a tourniquet was registered in the Danish Knee Arthroplasty Register. Postoperative VTE was identified from health records. We performed risk analyses using a mixed-effects logistic regression model adjusting for previously identified risk factors. Results — Of the 16,250 procedures (39% males, mean age 67.9 [SD 10.0] years, median LOS 2 [interquartile range 2–3]) 12,518 (77%) were performed with a tourniquet. The annual tourniquet usage varied greatly between departments from 0% to 100%, but also within departments from 0% to 99%. There was no significant difference between the 2 groups with 52 (0.42%) VTEs in the tourniquet group vs. 25 (0.67%) in the no-tourniquet group (p = 0.06 for cumulative 90-day incidence of VTE). This association remained statistically insignificant for VTE using tourniquet after adjustment for previously identified risk factors. Conclusion — We found no association between the use of a tourniquet and increased risk of 90-day VTE after primary fast-track TKA, irrespective of the length of time for which the tourniquet was applied.
AB - Background and purpose — Venous thromboembolism (VTE) is a serious postoperative complication after total knee arthroplasty (TKA). Use of a tourniquet has shown conflicting results for risk of VTE after TKA. We aimed to investigate the associated risk of VTE after TKA using tourniquet in a fast-track set-up as no previous data exists. Patients and methods — We performed an observational cohort study from 9 fast-track centers including unilateral primary TKA from 2010–2017 with prospective collection of preoperative risk-factors and complete 90-day follow-up. Use of a tourniquet was registered in the Danish Knee Arthroplasty Register. Postoperative VTE was identified from health records. We performed risk analyses using a mixed-effects logistic regression model adjusting for previously identified risk factors. Results — Of the 16,250 procedures (39% males, mean age 67.9 [SD 10.0] years, median LOS 2 [interquartile range 2–3]) 12,518 (77%) were performed with a tourniquet. The annual tourniquet usage varied greatly between departments from 0% to 100%, but also within departments from 0% to 99%. There was no significant difference between the 2 groups with 52 (0.42%) VTEs in the tourniquet group vs. 25 (0.67%) in the no-tourniquet group (p = 0.06 for cumulative 90-day incidence of VTE). This association remained statistically insignificant for VTE using tourniquet after adjustment for previously identified risk factors. Conclusion — We found no association between the use of a tourniquet and increased risk of 90-day VTE after primary fast-track TKA, irrespective of the length of time for which the tourniquet was applied.
U2 - 10.2340/17453674.2023.13793
DO - 10.2340/17453674.2023.13793
M3 - Journal article
C2 - 37417882
AN - SCOPUS:85171169600
VL - 94
SP - 342
EP - 347
JO - Acta Orthopaedica
JF - Acta Orthopaedica
SN - 1745-3674
ER -
ID: 396721899