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N/A N=60 Randomized Double-blind Health Services Research

Ischemic Preconditioning in Total Knee Arthroplasty

Total Knee Arthroplasty · Ischemic Preconditioning · Postoperative Pain

Enrolled (actual)
60
Serious AEs
0.0%
Results posted
Sep 2024
Primary outcome: Primary: Postoperative Pain at Rest and Exercise as Assessed by Visual Analogue Scale (VAS) Scores at 48h After Surgery — 1.75; .71; 3; 1.38 score on a scale — p=.043

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
Ischemic Preconditioning (Procedure)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Hospital for Special Surgery, New York
Primary completion
Apr 2012

Outcome Measures

OutcomeResultp-value
PRIMARY
Postoperative Pain at Rest and Exercise as Assessed by Visual Analogue Scale (VAS) Scores at 48h After Surgery
1.75; .71; 3; 1.38 .043 sig
SECONDARY
Overall Epidural Volume
140.5; 160.8 .043 sig
SECONDARY
Muscle Oxygenation Over Calf at 48h After Surgery
75; 69 .584
SECONDARY
Levels of Interleukin 6 (IL6) in Drainage Fluid at 24hr Postoperatively
3.79; 3.57 0.763
SECONDARY
Periarticular Circumference of the Knee at 6h, 24h, and 48h
2.3; 1.5 .602
SECONDARY
Hospital Length of Stay
100.6; 99.4 .8656
SECONDARY
Physical Therapy Milestone
2.0; 3.0 .8422
SECONDARY
Levels of Leukocytes in Drainage Fluid at 24hr Postoperatively
2487; 2038 .526
SECONDARY
Levels of TNF-alpha in Drainage Fluid at 24hr Postoperatively
3.72; 3.76 .526

Summary

The application of a tourniquet for 5 minutes and subsequent reperfusion before actual inflation of the tourniquet for total knee arthroplasty (ischemic preconditioning) decreases the level of local inflammation and therefore postoperative pain in response to reperfusion of the ischemic extremity.

Eligibility Criteria

Inclusion Criteria

  • All patients undergoing primary total knee arthroplasty

Exclusion Criteria

  • Patients who chronically use narcotics (<1 month).
  • Patients with contraindications (severe peripheral vascular disease, presence of femoral-popliteal bypass grafts, etc.) or no plan for tourniquet use as determined by the clinical care team.
  • Patients who are on corticosteroids prior to their surgery
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01333969). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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