Description
Objectives: Tourniquets are commonly used in orthopaedic procedures and the complications of tourniquets are widely known. However, few studies have reported the complications of tourniquet use after medial open wedge distal tuberosity osteotomy (MOWDTO). The purpose of this study was to examine the complications of tourniquet use after MOWDTO.
Methods: A total of 49 knees in 47 patients were followed-up for at least 2 years after MOWDTO between August 2018 and July 2021. Twenty-five patients (26 knees) underwent MOWDTO without the use of a tourniquet, and were enrolled in this study as the T+ group. From January 2019 to July 2021, a further 22 patients (23 knees) underwent MOWDTO without the use of a tourniquet, and were enrolled as the T- group. The incidence of postoperative deep vein thrombosis (DVT), operative time, blood loss, and hemoglobin (Hb) loss were compared between the T- and T+ groups. Blood loss was measured via intraoperative and postoperative bleeding from drains. A blood test was performed before and 7 days after surgery in order to detect any changes in Hb, and an ultrasonographic evaluation was bilaterally performed to detect DVT throughout the whole leg. Each patient was assessed based on the subjective International Knee Documentation Committee (IKDC) score and Knee Injury and Osteoarthritis Outcome Score (KOOS) before surgery and at the time of their 2-year follow-up. Statistical comparison among the groups was made using the unpaired t-test for parametric data and the Chi-square test for nonparametric variables. The significance level was set at a p value of less than 0.05.
Results: The mean blood loss was significantly lower in the T- group than in the T+ group (290.5 mL vs 395.8 mL; p=.045). The incidence of DVT was not significantly different (4.3% (1/23) in the T- group vs 15.4% (4/26) the T+ group;p=.198). There were no significant differences in operative time (92.9 minutes in the T- group vs 89.0 minutes in the T+ group; p=.528) or the change in Hb (-1.97 g/dL in the T- group vs -2.60 g/dL in the T+ group’ s=.057) between the two groups.
No statistical difference was found between groups for median IKDC subjective score (70.3 in the T- group vs 76.6 in the T+ group;p=.207) and KOOS (405 in the T- group vs 424 in the T+ group; p=.390) at 2 years postoperatively.
Conclusions: In this study, MOWDTO performed without the use of a tourniquet reduced the level of blood loss. However, the absence of a tourniquet did not affect the incidence of DVT, reduce operative time, or yield significant change in the loss of Hb.
