5. Discussion
postoperative pain, muscle damage, TKA, pain
PULMONARY EMBOLISM, THROMBOEMBOLIC EVENT, DEEP VEIN THROMBOSIS (DVT), INFLAMMATION, NA DEFICIENCY, WOUND INFECTIONS, COMPLICATIONS
The main findings of our study indicate that tourniquet application can be safely utilized in patients without comorbidities, as it does not lead to complications. Furthermore, the use of a tourniquet does not pose significant challenges compared to non-use, as it only results in easily manageable postoperative pain for 1–2 days without causing any additional distress. Over the years, an increasing number of studies have concluded that TKA without tourniquet use is superior to TKA with tourniquet use. Moreover, many studies have pointed out that the rates of thromboembolic events, wound infections, and other complications are lower when TKA is performed without a tourniquet [The most serious and potentially preventable complications in total knee prosthesis applications are deep vein thrombosis (DVT) and pulmonary embolism. However, no studies have indicated that the use of a tourniquet for such applications increases these risks [In the present study, the VAS scores decreased daily over the first three postoperative days, and there was significantly more pain in the tourniquet group during their hospital stay than in the non-tourniquet group. Thus, the non-tourniquet group exhibited reduced analgesic requirements during the initial postoperative days. While this concurs with the findings of some other studies [There are also diverse postoperative ROM values in the literature for patients who underwent TKA with or without a tourniquet. Ejaz et al. [In the studies by Smith et al. [In total knee prosthesis applications, it is known that tourniquet use reduces the metabolic stress response. The stress response, which is related to excessive postoperative inflammation and muscle damage which is measured with CRP and creatine phosphokinase levels, has been observed to decrease with the use of a tourniquet [This study was not without limitations. First, outcome measurement was continued for only 8 weeks postoperatively; however, as the aim of the present study was to investigate the effects of tourniquet use on early recovery after TKA, we deemed this period to be sufficiently inclusive. Second, tranexamic acid, which is commonly used in current arthroplasty practice was not included in the present study because it was not used in any of the patients in this study. Third, preoperative psychological evaluations were not conducted for the patients in this study, which is a deficiency in terms of postoperative pain management. Fourth, the data are nearly one decade old and some developments took place in surgical techniques. Finally, the sample size was small and insufficient to observe an adequate number of complications, and the study participants were from a single orthopedic center. Further multicentric studies with a greater number of patients are needed to confirm the findings of the present study.