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Mayer C, Franz A, Harmsen JF, et al. Soft-tissue damage during total knee arthroplasty: Focus on tourniquet-induced metabolic and ionic muscle impairment. J Orthop. 2017;14(3):347-353doi: 10.1016/j.jor.2017.06.015.
Mayer, C., Franz, A., Harmsen, J. F., Queitsch, F., Behringer, M., Beckmann, J., Krauspe, R., & Zilkens, C. (2017). Soft-tissue damage during total knee arthroplasty: Focus on tourniquet-induced metabolic and ionic muscle impairment. Journal of orthopaedics, 14(3), 347-353. https://doi.org/10.1016/j.jor.2017.06.015
Mayer, Constantin, et al. "Soft-tissue damage during total knee arthroplasty: Focus on tourniquet-induced metabolic and ionic muscle impairment." Journal of orthopaedics vol. 14,3 (2017): 347-353. doi: https://doi.org/10.1016/j.jor.2017.06.015
Mayer C, Franz A, Harmsen JF, Queitsch F, Behringer M, Beckmann J, Krauspe R, Zilkens C. Soft-tissue damage during total knee arthroplasty: Focus on tourniquet-induced metabolic and ionic muscle impairment. J Orthop. 2017 Jun 24;14(3):347-353. doi: 10.1016/j.jor.2017.06.015. eCollection 2017 Sep. PMID: 28706378; PMCID: PMC5496200.
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J Orthop. 2017 Jun 24;14(3):347-353. doi: 10.1016/j.jor.2017.06.015. eCollection 2017 Sep.

Soft-tissue damage during total knee arthroplasty: Focus on tourniquet-induced metabolic and ionic muscle impairment.

Journal of orthopaedics

Constantin Mayer, Alexander Franz, Jan-Frieder Harmsen, Fina Queitsch, Michael Behringer, Johannes Beckmann, Rüdiger Krauspe, Christoph Zilkens

Affiliations

  1. Department of Orthopaedics, Medical Faculty, University Düsseldorf, Düsseldorf, Germany.
  2. Institute of Training Science and Sports Informatics, German Sport University Cologne, Germany.
  3. Department of Orthopaedics, Sportklinik Stuttgart, Stuttgart, Germany.

PMID: 28706378 PMCID: PMC5496200 DOI: 10.1016/j.jor.2017.06.015

Abstract

PURPOSE: Advantages of tourniquet use in TKA include benefits for surgeons and patients, varying from a bloodless operation site to a reduced intervention time. The time under ischemia and the reperfusion period are crucial phases for affected soft-tissue, most commonly the extensor mechanism.

CASE REPORTS: documented its impact on soft-tissue, ranging from necrotic muscle damage to systemic inflammation. Recently, research regarding tourniquet application patterns discuss clinical outcome parameters in the context of soft-tissue damage, excluding the underlying pathophysiological mechanisms.

METHODS: This review summarizes the molecular aspects of soft-tissue damage occurring during tourniquet application in TKA with special focus on ischemia/reperfusion injury. Recent meta-analyses and original trials were reviewed for data on muscle damage and are presented.

CONCLUSION: Although underlying pathomechanisms are well known and presented, clinical orthopedic research has so far not addressed this issue. In context of physical training, positive effects regarding postoperative recovery might be possible if more attention is paid to prepare involved muscle preoperatively to TKA (prehabilitation).

Keywords: Arthroplasty; Muscle; Prehabilitation; Soft tissue; TKA; Tourniquet

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