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Abstract：
BACKGROUND: During total knee arthroplasty(TKA), tourniquet is widely used by most surgeons whereas the optimal application is still controversial. With this prospective randomized controlled study, we intend to investigate the effect of lower limb lifting and squeeze exsanguination methods on clinical outcomes in a series of TKAs.
METHODS: Prospectively enrolled a total of 236 TKA patients from March, 2012 to November, 2016. Of which 118 patients randomly constitute Group A with lower limb lifting exsanguination technique; and the other 118 patients comprise Group B with squeeze exsanguination method. A year\'s follow-up measurements were recorded in detail for analysis.
RESULTS: The pre-tourniquet time of Group A was significantly shorter than that in Group B (P < 0.001). Significant difference was found on skin tension blister, 3 happened in Group A and 11 happened in Group B (P = 0.031), which resulted in a difference in total complications (P = 0.039). The VAS score was significantly lower in Group A at one and seven days postoperatively, P < 0.001 and P = 0.011, respectively. No significant differences were found regarding all other clinical outcome measurements.
CONCLUSIONS: The lower limb lifting exsanguination is a safe and effective technique. Compared with squeeze exsanguination method, it could decrease the incidence of skin tension blister and alleviate early postoperative pain reaction, no additional risks occurred regarding other clinical outcomes. Thus, it might have the potentiality to be commonly utilized in TKA procedure.
BACKGROUND: ClinicalTrials.gov Identifier: ChiCTR1800020471. Registered on 31 December 2018 Retrospectively registered.
METHODS: Prospectively enrolled a total of 236 TKA patients from March, 2012 to November, 2016. Of which 118 patients randomly constitute Group A with lower limb lifting exsanguination technique; and the other 118 patients comprise Group B with squeeze exsanguination method. A year\'s follow-up measurements were recorded in detail for analysis.
RESULTS: The pre-tourniquet time of Group A was significantly shorter than that in Group B (P < 0.001). Significant difference was found on skin tension blister, 3 happened in Group A and 11 happened in Group B (P = 0.031), which resulted in a difference in total complications (P = 0.039). The VAS score was significantly lower in Group A at one and seven days postoperatively, P < 0.001 and P = 0.011, respectively. No significant differences were found regarding all other clinical outcome measurements.
CONCLUSIONS: The lower limb lifting exsanguination is a safe and effective technique. Compared with squeeze exsanguination method, it could decrease the incidence of skin tension blister and alleviate early postoperative pain reaction, no additional risks occurred regarding other clinical outcomes. Thus, it might have the potentiality to be commonly utilized in TKA procedure.
BACKGROUND: ClinicalTrials.gov Identifier: ChiCTR1800020471. Registered on 31 December 2018 Retrospectively registered.
摘要：
背景：在全膝关节置换术（TKA）期间，大多数外科医生广泛使用止血带，而最佳应用仍存在争议。通过这项前瞻性随机对照研究，我们打算在一系列TKAs中研究下肢抬起和挤压放血方法对临床结局的影响.
方法：从3月开始，前瞻性招募了236名TKA患者，2012年至11月,2016年。其中118例患者随机组成A组，采用下肢抬起放血技术；另外118例患者为B组，采用挤压放血方法。详细记录一年的随访测量结果以进行分析。
结果：A组止血带前时间明显短于B组（P<0.001）。皮肤张力起泡有显著性差异，A组3例,B组11例(P=0.031),这导致了总并发症的差异（P=0.039）。术后1天和7天，A组VAS评分明显较低，P分别<0.001和P=0.011。关于所有其他临床结果测量没有发现显著差异。
结论：下肢抬起放血是一种安全有效的技术。与挤压放血法相比，能降低皮肤张力性水疱的发生率，减轻术后早期疼痛反应，其他临床结局未出现额外风险.因此，它可能有可能在TKA手术中普遍使用。
背景：ClinicalTrials.gov标识符：ChiCTR1800020471。2018年12月31日注册回顾性注册。
方法：从3月开始，前瞻性招募了236名TKA患者，2012年至11月,2016年。其中118例患者随机组成A组，采用下肢抬起放血技术；另外118例患者为B组，采用挤压放血方法。详细记录一年的随访测量结果以进行分析。
结果：A组止血带前时间明显短于B组（P<0.001）。皮肤张力起泡有显著性差异，A组3例,B组11例(P=0.031),这导致了总并发症的差异（P=0.039）。术后1天和7天，A组VAS评分明显较低，P分别<0.001和P=0.011。关于所有其他临床结果测量没有发现显著差异。
结论：下肢抬起放血是一种安全有效的技术。与挤压放血法相比，能降低皮肤张力性水疱的发生率，减轻术后早期疼痛反应，其他临床结局未出现额外风险.因此，它可能有可能在TKA手术中普遍使用。
背景：ClinicalTrials.gov标识符：ChiCTR1800020471。2018年12月31日注册回顾性注册。
