Surgical Information – Procedures

Tourniquet-less Total Knee Replacement

What is Tourniquet-less Total Knee Replacement?

Traditionally, orthopaedic surgeons have used a thigh tourniquet to reduce bleeding during total knee replacement. Similar to a blood pressure cuff, the tourniquet is placed around a patient's thigh and inflated, cutting off the blood supply to the leg. The vast majority of total knee replacements in the United States are still performed this way.

However, as evidence grows that eliminating the use of a tourniquet improves patient outcomes, a handful of surgeons are opting to perform tourniquet-less total knee replacement. Dr. Madden is one of them. At Commonwealth Orthopaedics, he performs all of his total knee replacement surgeries without a tourniquet.

What are the Advantages of Tourniquet-less Total Knee Replacement?

Benefits include:

  • Less blood loss. Bleeders are addressed during surgery, while the incision is open and the surgeon has a full view.
  • Less local tissue trauma, nerve and muscle damage because blood supply to the leg is not choked off.
  • Less post-operative pain because the thigh is not compressed.
  • Less risk of deep vein thrombosis, infection or blood clots during and after surgery.
  • Easier rehabilitation. With less trauma to the quadriceps muscle, patients tend to have better range of motion and leg strength immediately following surgery. Post-operative knee stiffness is also reduced.
  • Fewer post-operative complications such as infection and hematoma.
  • Less risk of MSRA, a bacterial infection that is resistant to antibiotics.
  • Faster recovery. All of the benefits above improve recovery time for patients.

How is Blood Loss Controlled During Tourniquet-less Total Knee Replacement?

Dr. Madden uses a state-of-the-art cautery device with patented technology that seals soft tissue and bone during surgery and reduces blood loss.

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