Tourniquet less Minimally Invasive Total Knee Replacement
For patients who have arthritis of the knee, I (Dr. Bright) sometimes recommend specific exercises, weight loss, medications, injections and bracing. Our advanced digital X-Ray system uses minimal radiation and can pin point your disease. If non-operative treatment has failed to control your pain or limits your activity, then knee replacement may be the best solution.
For patients with arthritis limited to a certain portion of the knee, partial knee replacement can preserve the rest of your knee and is less invasive. When the arthritis involves the entire knee and conservative (non-operative) measures have failed, then total knee replacement can provide a long lasting, durable pain relief. Statistics have proven that physicians such as myself, who have performed thousands of both hip and knee replacements, have better results than other surgeons. My current technique of using custom guides to replace knees improves accuracy of the knee replacement and minimizes the chance of complications.
Multiple research articles have shown that performing your knee replacement without a tourniquet improves your post surgical pain and improves your range of motion and minimizes the chances of a complication. Patients like mine, who have knee replacement without a tourniquet, have less pain and require less pain medication and recover better range of motion. Lastly, avoiding use of the tourniquet also results in less bloodloss. Surgeons who do surgery with the tourniquet cannot identify the severed bleeding vessels, and several research studies have shown that avoiding the toruniquet and taking the time to stop each and every bleeding vessel results in less overall blood loss.
Performing the knee replacement without a tourniquet also helps to diminish complications. Since the knee is not getting blood when the tournquet is in place, the tissue and skin is deprived of oxygen and nutrition and can become damaged, resulting in difficulty with the healing of the wound and increased wound drainage and increased chance of infection. The tourniquet stops all blood from flowing through the blood vessels, and when the blood flow is stopped, there is a higher chance fo developing a blood clot. Lastly, patients who develop stiffness afer knee replacement sometimes require a return to surgery to manipulate the knee while the patient is under anesthesia. Avoiding the tourniquet results in less muscle damage and less stiffness and less pain, so the patient has less risk of requiring a secone surgery (manipulation).
Although I (Dr. Bright) was trained to replace knees with a tourniquet, he has since evolved his technique Since 2018, I have not used a tourniquet for knee replacement. By avoiding the tourniquet, many of my patients are able to have outpatient knee replacement since it is less painful and less invasive and has a lower chance of complications.
- Less (minimally) invasive
- Lower chance of blood clots
- Less Pain
- Less chance of manipulation
- Less Stiffness
Patients who do some physical therapy exercises before their surgery (prehab), usually recover faster.
Here is an article about Prehab: