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Tourniquets for the use of total knee arthroplasty : are patients aware of the risks?
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Ahmed, Imran, Fraser, Louise, Sprowson, Andrew P. and Wall, Peter D. H. (2016) Tourniquets for the use of total knee arthroplasty : are patients aware of the risks? Annals of Orthopedics & Rheumatology, 4 (3). 1071. ISSN 2334-2846 .
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Abstract
Background: Tourniquets are routinely used in total knee arthroplasty (TKA) with an estimated use by up to 93% of surgeons. Advantages include the ability to provide a bloodless field of view to facilitate cement application and increase the success of the procedure. Overall reduction in blood loss is another perceived advantage; however recent research has demonstrated no measurable reduction and conversely a substantial increase in complications such as deep vein thrombosis and systemic emboli. Given the significant complications of tourniquet use we aim to identify patients' views on tourniquets and of emphasis their awareness of the possible risks involved prior to the procedure.
Method: A questionnaire - based study was carried out on 35 patients attending an elective orthopaedic centre for TKA surgery. Ethical approval was granted by NRES committee - East of England (REC Ref: 14/EE/1265). Patients were provided with an information sheet detailing the reasons for the tourniquet use and the associated risks and benefits. They were then provided with a questionnaire to ascertain their views and previous understanding of the subject. Simple statistical measures were implemented to analyse the data.
Results: Only 32% of patients were aware of the use of tourniquets during the operation. 19% were aware of the benefits prior to reading the information sheet provided with 29% understanding the risks involved prior to their procedure. Finally we found 97% of patients would like more information on the use of tourniquets preoperatively.
Conclusion: Tourniquets are widely used in TKA surgery; however, they carry significant risks which are not clearly relayed preoperatively to all patients. Given that 91,000 TKA operations are performed per year we believe it is of paramount importance that all patients are appropriately counselled on the risks and benefits of its use and fully informed consent, including risks of tourniquet use, should be obtained prior to the procedure.
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > RD Surgery | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Total knee replacement -- Risk factors, Tourniquets, Hemorrhage | ||||||||
| Journal or Publication Title: | Annals of Orthopedics & Rheumatology | ||||||||
| Publisher: | Avens Publishing Group | ||||||||
| ISSN: | 2334-2846 | ||||||||
| Official Date: | 20 July 2016 | ||||||||
| Dates: |
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| Volume: | 4 | ||||||||
| Number: | 3 | ||||||||
| Article Number: | 1071 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||||
| Date of first compliant deposit: | 9 August 2016 | ||||||||
| Date of first compliant Open Access: | 10 August 2016 | ||||||||
| Related URLs: |
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