2023 ISAKOS Biennial Congress ePoster
No tourniquet reduces the incidence of asymptomatic deep venous thrombosis identified on ultrasonography after arthroscopic anterior cruciate ligament reconstruction: an observational study
Masaki Nagashima, MD, PhD, Prof., Mitaka, Tokyo JAPAN
Ryo Sasaki, MD, PhD, Shinjuku-Ku, Tokyo JAPAN
Kentaro Tanaka, MD, Minato-Ku, 東京都 JAPAN
Kenichiro Takeshima, MD, Chiba JAPAN
Ken Ishii, MD, PhD, Minato-ku, Tokyo JAPAN
Dept. of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, Japan, Minato-ku, Tokyo, JAPAN
FDA Status Not Applicable
Summary
ACLRs performed without tourniquet resulted in a significantly lower incidence of DVT than that with tourniquet after ACLR.
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Abstract
Background
Deep venous thrombosis (DVT) and pulmonary embolism are serious potential complications following anterior cruciate ligament reconstruction (ACLR). Several risk factors have been reported for DVT after ACLR. However, little is known about the influence of tourniquet use on the incidence of DVT. The purpose of this study was to compare the incidence of DVT after ACLR with and without the use of a tourniquet.
Methods
Between November 2018 and May 2020, 60 consecutive ACLRs in 60 patients including 7 revision surgeries were performed without tourniquet use at our hospital and enrolled in this study (T- group). The incidence of DVT after ACLR in the T- group were compared to that of the control group and consisted of 55 consecutive ACLRs in 55 patients including 10 revision surgeries with tourniquet use at our hospital between April 2017 and September 2018 (T+ group). DVT was diagnosed using ultrasonography of both legs performed preoperatively and at one postoperative week.
Results
No preoperative DVT was detected. After ACLR, DVT was detected in 9 patients (16.4%) in the T+ group and 1 patient (1.7%) in the T- group. The incidence of DVT was significantly lower in the T- group (P = 0.005). All patients with DVT were asymptomatic. Although the mean operative time was not significantly different between the two groups, 80.8 minutes in the T+ group and 78.5 minutes in the T- group (P = 0.461), the mean blood loss from the drain was significantly lower in the T- group (149.9 ml) than in the T+ group (201.9 ml) (P < 0.001).
Conclusion
ACLRs performed without tourniquet resulted in a significantly lower incidence of DVT after ACLR and significantly less bleeding from drains, although there was no difference in operative time. If adequate visibility of the surgical field is obtained, ACLR without tourniquet use may reduce the incidence of DVT.