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Early Outcome of Simultaneous Bilateral Total Knee Replacement With and Without Tourniquet
Sponsor: Shifa International Hospital
Summary
This randomized controlled trial compared early outcomes after replacement of both knees during the same operation, with and without tourniquet use. A tourniquet was an inflatable cuff placed around the upper thigh and tightened during surgery to temporarily restrict blood flow. The study tested the hypothesis that tourniquet use would reduce blood loss during and after surgery, preserve hemoglobin levels, and reduce early postoperative pain. Hemoglobin was the protein in red blood cells that carried oxygen. The study was designed to include 84 patients aged 40-80 years at the Department of Orthopedic Surgery, Shifa International Hospital, Islamabad. Patients were randomly assigned to two equal groups of 42. One group underwent replacement of both knees with tourniquet use, while the other underwent the same procedure without tourniquet inflation. Both groups received standardized surgical care, pain management, blood clot prevention, and rehabilitation. The outcomes assessed were blood loss during surgery, blood collected through drains from both knees during the first 24 hours after surgery, hemoglobin levels at 24 hours, and the decrease from preoperative hemoglobin levels. Pain in each knee was assessed at 24 and 48 hours using a scale from 0, indicating no pain, to 10, indicating the worst possible pain. These measurements were compared between the two groups to assess the effect of tourniquet use on early recovery.
Key Details
Gender
All
Age Range
40 Years - 80 Years
Study Type
INTERVENTIONAL
Enrollment
84
Start Date
2026-07-01
Completion Date
2027-01-30
Last Updated
2026-10-29
Healthy Volunteers
No
Interventions
Simultaneous Bilateral Total Knee Replacement with Tourniquet
Both knees were replaced during a single anesthetic session using cemented components. A pneumatic tourniquet was placed around the proximal thigh of each limb and inflated to 100 mmHg above systolic blood pressure immediately before the incision for that limb. Tourniquet release and hemostasis followed the standardized surgical protocol.
Simultaneous Bilateral Total Knee Replacement without Tourniquet
Both knees were replaced during a single anesthetic session using cemented components. Tourniquet cuffs were not inflated. Hemostasis was maintained throughout surgery using electrocautery and standard surgical techniques.
Locations (1)
Shifa International Hospital, Islamabad
Islamabad, Fedral, Pakistan