2.2. Surgical Technique
knee arthroplasty, Arthritis, femoral nerve block, TKA
ARTHRITIS, COMPLICATIONS, DEEP VEIN THROMBOSIS
All TKA procedures were performed by a single, highly experienced orthopedic surgeon in our institution, who specializes in total knee arthroplasty, according to a standard protocol. The implant of choice was the Zimmer Biomet NexGen implant system. Preoperatively, 1 g of tranexamic acid was administered in all cases, with an additional 1 g administered after the procedure. All cases received spinal anesthetic with a femoral nerve block. For the T group cases, a tourniquet was installed after three minutes of elevating the lower limb, which was inflated up to 350 mm Hg prior to the incision and deflated after the implantation, in order to perform hemostasis. We used a parapatellar approach, an intramedullary femoral guide with posterior referencing, an extramedullary tibial guide and a measured resection technique. For all cases, we routinely resurfaced the patella. All cases received a deep drain, and the wound closure was performed in a layered fashion. The drain was clamped for 3 h and then released and removed 24 h after surgery. Patients began physical therapy the following day and received chemoprophylaxis for deep vein thrombosis. Physical therapy was continued either at home or in a specialized clinic.We recorded preoperative data, which included age, sex, knee range of motion and Western Ontario and McMaster Universities Arthritis Index scores (WOMAC Score). Intraoperatively we measured the amount of blood aspiration by taking into account the amount of physiological serum used for lavage and the surgical room time. After the surgical procedure, we measured the amount of blood aspirated through the drains and the hemoglobin. For the functional evaluation, we measured flexion, extension, Visual Analogue Scale (VAS) scores and WOMAC scores after 6 weeks and 6 months. All complications were recorded throughout the whole study.