Description
Abstract
Objectives: It is still controversial whether a tourniquet should be used during anterior cruciate ligament reconstruction (ACLR) when the surgical visibility is secured. The influence of not using a tourniquet on overall perioperative blood loss and soft tissue damage is little known. The purpose of this study was to compare total perioperative blood loss and soft tissue damage with and without tourniquet use during ACLR.
Methods: Seventy-seven consecutive ACLRs in 76 patients were performed without tourniquet use at our hospital and enrolled in this study (T- group) between November 2018 and September 2021. The control group (T+ group) comprised 55 historical ACLRs in 55 patients performed with tourniquet use at our hospital between April 2017 and September 2018. Total perioperative blood loss, calculated from the change in hemoglobin between that preoperatively and on postoperative day (POD) 1, and indicators of soft tissue damage including serum white blood cell (WBC) counts, creatine phosphokinase (CPK), and C-reactive protein (CRP) values measured on POD 1 and POD 7 were compared between groups.
Results: Total blood loss was significantly higher in the T- group (339±216 mL) than in the T+ group (258±199 mL; P=0.030). On POD 1, WBC counts were significantly higher in the T- group (9.7±2.4 ×103 cells/µL) than in the T+ group (9.1±2.5 ×103 cells/µL; P=0.043), CPK levels were significantly higher in the T- group (294±417 U/L) than in the T+ group (255±88 U/L; P=0.046), and CRP levels were also significantly higher in the T- group (1.40±1.12 mg/dL) than in the T+ group (0.91±0.76 mg/dL; P=0.016). No significant differences in WBC counts or CPK or CRP levels were seen between groups on POD 7.
Conclusions: Without tourniquet use during ACLR, total blood loss and soft tissue damage were significantly increased. No advantage was found for not using a tourniquet in terms of blood loss or soft tissue damage.
