Longer tourniquet application time during knee surgery decreases the quadriceps muscle strength: a prospective study on 25 consecutive patients underwent total knee arthroplasty

The use of tourniquets in total knee arthroplasty (TKA) for patients with knee osteoarthritis is controversial. Although surgical techniques are more easily applied in a shorter time; there are some disadvantages associated with tourniquet use in orthopedic surgery. The aim of this study was to evaluate the effect of the tourniquet time on quadriceps strength by isokinetic muscle strength measurements in patients undergoing TKA. Prospective controlled study. Twenty-five knees of 25 patients with primary degenerative joint disease who underwent TKA were evaluated preoperatively and postoperatively at weeks 6 and 12 and month 6 by isokinetic knee extensor muscle strength testing at and American Knee Society Score (AKSS). The tourniquet time of all patients was recorded, and the preoperative results of all patients were compared with those postoperatively. The mean 60º/s angular velocity quadriceps peak torque was significantly lower postoperatively in patients with a longer tourniquet time. Isokinetic tests showed a significant negative correlation between the tourniquet time and mean muscle strength (week 6: r = –0.718, p < 0.01; week 12: r = –0.651, p < 0.01; month 6: r = –0.672, p < 0.01). The highest correlation with tourniquet time was obtained 6 weeks after surgery. Additionally, strong negative correlations were observed between the AKSS and tourniquet times (Knee Score: r = –0.904, p < 0.01; Knee Functional Score: r = –0.878, p < 0.01). Lower postoperative mean quadriceps strength in patients with a longer tourniquet time, suggesting that the tourniquet time affects the quadriceps muscle strength witl longer times resulting lower muscle strengthThe use of tourniquets in total knee arthroplasty (TKA) for patients with knee osteoarthritis is controversial. Although surgical techniques are more easily applied in a shorter time; there are some disadvantages associated with tourniquet use in orthopedic surgery. The aim of this study was to evaluate the effect of the tourniquet time on quadriceps strength by isokinetic muscle strength measurements in patients undergoing TKA. Prospective controlled study. Twenty-five knees of 25 patients with primary degenerative joint disease who underwent TKA were evaluated preoperatively and postoperatively at weeks 6 and 12 and month 6 by isokinetic knee extensor muscle strength testing at and American Knee Society Score (AKSS). The tourniquet time of all patients was recorded, and the preoperative results of all patients were compared with those postoperatively. The mean 60º/s angular velocity quadriceps peak torque was significantly lower postoperatively in patients with a longer tourniquet time. Isokinetic tests showed a significant negative correlation between the tourniquet time and mean muscle strength (week 6: r = –0.718, p < 0.01; week 12: r = –0.651, p < 0.01; month 6: r = –0.672, p < 0.01). The highest correlation with tourniquet time was obtained 6 weeks after surgery. Additionally, strong negative correlations were observed between the AKSS and tourniquet times (Knee Score: r = –0.904, p < 0.01; Knee Functional Score: r = –0.878, p < 0.01). Lower postoperative mean quadriceps strength in patients with a longer tourniquet time, suggesting that the tourniquet time affects the quadriceps muscle strength witl longer times resulting lower muscle strengt

Longer tourniquet application time decreases the quadriceps muscle strength: a prospective study on 25 consecutive patients underwent total knee arthroplasty

The use of tourniquets in total knee arthroplasty (TKA) for patients with knee osteoarthritis is controversial. Although surgical techniques are more easily applied in a shorter time; there are some disadvantages associated with tourniquet use in orthopedic surgery. The aim of this study was to evaluate the effect of the tourniquet time on quadriceps strength by isokinetic muscle strength measurements in patients undergoing TKA. Prospective controlled study. Twenty-five knees of 25 patients with primary degenerative joint disease who underwent TKA were evaluated preoperatively and postoperatively at weeks 6 and 12 and month 6 by isokinetic knee extensor muscle strength testing at and American Knee Society Score (AKSS). The tourniquet time of all patients was recorded, and the preoperative results of all patients were compared with those postoperatively. The mean 60º/s angular velocity quadriceps peak torque was significantly lower postoperatively in patients with a longer tourniquet time. Isokinetic tests showed a significant negative correlation between the tourniquet time and mean muscle strength (week 6: r = 0.718, p &lt; 0.01; week 12: r = 0.651, p &lt; 0.01; month 6: r = 0.672, p &lt; 0.01). The highest correlation with tourniquet time was obtained 6 weeks after surgery. Additionally, strong negative correlations were observed between the AKSS and tourniquet times (Knee Score: r = 0.904, p &lt; 0.01; Knee Functional Score: r = 0.878, p &lt; 0.01). Lower postoperative mean quadriceps strength in patients with a longer tourniquet time, suggesting that the tourniquet time affects the quadriceps muscle strength witl longer times resulting lower muscle strength. [Med-Science 2017; 6(1.000): 86-90

Comparison of effectiveness of kyphoplasty and vertebroplasty in patients with osteoporotic vertebra fractures

Objective: The aim of this study was to compare the functional and radiological outcomes of vertebroplasty and kyphoplasty in patients with osteoporotic vertebra fractures. Methods: The files of the patients who underwent vertebroplasty or kyphoplasty for osteoporotic vertebrae fractures were retrieved from the archives. Forty-three patients with complete follow-up data were included in the study group. The patients were evaluated for radiological outcomes in terms of local kyphosis angle, wedging index, compression ratio, visual analog pain scale (VAS) and Oswestry Disability Index (ODI). Results: In the study group, kyphoplasty was performed on 24 vertebrae of 22 patients (17 females, 5 males; mean age: 73 years) whereas vertebroplasty was applied on 24 vertebrae of 21 (16 females, 5 males; mean age: 74.7 years) patients. The mean follow-up time was 26 months. When the VAS and ODI values of the groups were analyzed, both groups showed statistically significant progress after the operation. Radiological data showed that the kyphoplasty group showed statistically significant improvement in the sagittal index values whereas the vertebroplasty group did not. The overall complication ratio was 4\%. Conclusion: Both vertebroplasty and kyphoplasty are effective treatment methods for functional recovery and pain relief in osteoporotic fractures of the vertebra. Although radiological outcomes of the kyphoplasty seem to be better, this does not have any clinical relevance. We suggest vertebroplasty over kyphoplasty since it is an easier method to manage. (C) 2016 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B. V. This is an open access article under the CC BY-NC-ND license