scholarly journals Patients Receiving a Primary Unicompartmental Knee Replacement Have a Higher Risk of Revision but a Lower Risk of Mortality Than Predicted Had They Received a Total Knee Replacement: Data From the National Joint Registry for England, Wales, Northern Ireland, and the Isle of Man

2020 ◽  
Author(s):  
Linda P. Hunt ◽  
Ashley W. Blom ◽  
Gulraj S. Matharu ◽  
Setor K. Kunutsor ◽  
Andrew D. Beswick ◽  
...  
Keyword(s):  
Northern Ireland ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Lower Risk ◽  
Unicompartmental Knee Replacement ◽  
National Joint Registry ◽  
Joint Registry ◽  
Isle Of Man ◽  
Risk Of Mortality ◽  
Total Knee

scholarly journals Effect of tourniquet use on the risk of revision in total knee replacement surgery: an analysis of the National Joint Registry Data Set

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e045353
Author(s):  
Muhamed M Farhan-Alanie ◽  
Yujin Lee ◽  
Martin Underwood ◽  
Andrew Metcalfe ◽  
Mark J Wilkinson ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Cox Regression ◽  
National Joint Registry ◽  
Data Set ◽  
Cement Interface ◽  
Joint Registry ◽  
Replacement Surgery ◽  
Primary Surgery ◽  
Total Knee

ObjectiveTourniquet use in total knee replacement (TKR) is believed to improve the bone-cement interface by reducing bleeding, potentially prolonging implant survival. This study aimed to compare the risk of revision for primary cemented TKR performed with or without a tourniquet.DesignWe analysed data from the National Joint Registry (NJR) for all primary cemented TKRs performed in England and Wales between April 2003 and December 2003. Kaplan-Meier plots and Cox regression were used to assess the influence of tourniquet use, age at time of surgery, sex and American Society of Anaesthesiologists (ASA) classification on risk of revision for all-causes.ResultsData were available for 16 974 cases of primary cemented TKR, of which 16 132 had surgery with a tourniquet and 842 had surgery without a tourniquet. At 10 years, 3.8% had undergone revision (95% CI 2.6% to 5.5%) in the no-tourniquet group and 3.1% in the tourniquet group (95% CI 2.8% to 3.4%). After adjusting for age at primary surgery, gender and primary ASA score, the HR for all-cause revision for cemented TKR without a tourniquet was 0.82 (95% CI 0.57 to 1.18).ConclusionsWe did not find evidence that using a tourniquet for primary cemented TKR offers a clinically important or statistically significant reduction in the risk of all-cause revision up to 13 years after surgery. Surgeons should consider this evidence when deciding whether to use a tourniquet for cemented TKR.

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