Comparative study between thromboembolism and total knee arthroplasty with or without tourniquet in rheumatoid arthritis patients

To investigate whether the occurrence of pulmonary embolism (PE) and/or deep vein thrombosis (DVT) are influenced by use of a tourniquet or not in the patients who underwent total knee arthroplasty for rheumatoid arthritis (RA). The patients were randomly divided into a with-tourniquet group (19 patients) and a without-tourniquet group (18 patients). In the first group, snowstorm-like echogenic particles were observed after deflation of the tourniquet in all patients according to the transesophageal echocardiography. In addition, the PaO(2) level was significantly decreased. Also, one had a PE, and DVT was confirmed in two patients. In the without-tourniquet group, none of these conditions was noted. These results suggest that the use of a tourniquet will promote the risk of developing postoperative PE and/or DVT after total knee arthroplasty.