# Effect of Tourniquet Release Timing on Blood Loss, Surgical Time, and Wound Outcomes in Total Knee Arthroplasty: A Prospective Comparative Study

## TL;DR

This study found that when a tourniquet is released during knee replacement surgery does not significantly affect blood loss, surgery time, or wound healing.

## Contribution

The study provides region-specific evidence on tourniquet release timing in TKA, using objective assessment tools.

## Key findings

- No significant difference in haemoglobin drop between tourniquet release before or after wound closure.
- No significant difference in intra-articular haematoma volume or operative time between the two groups.
- No wound complications observed in either group at one-week follow-up.

## Abstract

Background

The timing of tourniquet release in total knee arthroplasty (TKA) remains a topic of debate, with studies suggesting varying impacts on blood loss, operative time, and wound healing. Despite widespread global research, data from our region are limited, and objective assessment tools remain underutilised.

Methods

We conducted a prospective comparative study involving 113 patients undergoing primary TKA. Patients were assigned to one of two groups: Group A (tourniquet released before wound closure) and Group B (released after closure). All surgeries were standardised in terms of technique, prosthesis, and personnel. Outcomes included post-operative haemoglobin drop, intra-articular haematoma volume (measured via ultrasound), operative time, and wound healing at one-week follow-up.

Results

There was no significant difference between the two groups in haemoglobin drop (p = 0.877), intra-articular haematoma volume (p = 0.794), or operative time (p = 0.051). No wound complications were observed in either group.

Conclusion

The timing of tourniquet release, before or after wound closure, did not significantly affect post-operative blood loss, haematoma formation, operative time, or short-term wound healing. Surgeons may safely individualise release timing based on preference and intraoperative factors, provided tourniquet pressure and duration remain within safe thresholds.