Relationship between the Tourniquet Pressure and the Amount of Subcutaneous Bleeding after Total Knee Replacement

Received: December 20, 2010 Revised: January 18, 2011 Accepted: January 31, 2011 Corresponding author: Song Lee, M.D. Department of Orthopedic Surgery, Seoul Sacred Heart General Hospital, 40-12 Chungryangni-dong, Dongdaemun-gu, Seoul 130-010, Korea TEL: 82-2-966-1616, FAX: 82-2-968-2394 E-mail: songlee0903@hanmail.net Purpose: We wanted to evaluate the post-operative amount of subcutaneous bleeding according to the tourniquet pressure during total knee replacement. Materials and Methods: We analyzed 136 patients who had undergone total knee replacement at our hospital from March 4th, 2010 to September 16th, 2010. A tourniquet pressure of 250 mm Hg was applied to 69 patients (group I) and a tourniquet pressure of 320 mm Hg was applied to the other 67 patients (group II). Subcutaneous bleeding was evaluated on the 3rd and 6th days after the operations. All of the total knee replacements were performed by a single surgeon. Results: Among the group I patients, subcutaneous bleeding was seen in just 2 patients, yet among the group II patients, there were 32 patients with subcutaneous bleeding on the 3rd day and 33 patients with subcutaneous bleeding on the 6th day. According to the multiple regression analysis, there were no significant differences in ages, the tourniquet time and the orders between the two groups. Group 1 had significantly less subcutaneous bleeding than did group II on the 3rd and 6th days after the operations (p=0.001). Conclusion: There was a significant difference of the amount of subcutaneous bleeding amount according to the tourniquet pressure. We were able to decrease the post-operative amount of subcutaneous bleeding after total knee replacement by lowering the tourniquet pressure to 250 mm Hg.