Sharp Dissection Versus Monopolar Electrocautery in Primary Total Knee Arthroplasty Performed Under Tourniquet
Sharp Dissection Versus Monopolar Electrocautery in Primary Total Knee Arthroplasty Performed Under Tourniquet
This study compares the use of sharp dissection with diathermy for the approach to a total
 knee replacement. Half of the patients will be randomly assigned each intervention.
The approach to the knee to carry out a total knee replacement (TKR) can either be carried
 out using a scalpel, sharp dissection, or using an electric current to divide tissue,
 monopoly electrocautery. Reducing blood loss is important. Blood loss can result in anaemia,
 which has a number of effects including shortness of breath, chest pain and lethargy. Blood
 loss into a newly replaced knee can also result in pain and stiffness in the joint. Total
 knee replacements are routinely carried out with a tourniquet inflated, which reduces the
 blood flow into to leg during the operation. Diathermy is applied to areas of bleeding to
 stop them from doing so during operations. With the tourniquet inflated, some areas that
 would bleed when this was deflated may not be noticed and continue to bleed. Using diathermy
 for the approach would be expected to reduce this bleeding compared to using a scalpel.
Inclusion Criteria:

 -  Primary knee osteoarthritis requiring TKA (total knee arthroplasty)

 -  Planned for cruciate retaining prosthesis without patella resurfacing

 -  Patient is able to give informed consent

 -  Patient resides locally and will be available for follow up

 Exclusion Criteria:

 -  Cardiac pacemaker

 -  Inflammatory arthropathy

 -  Tourniquet contraindicated

 -  Thrombophilia/haemoglobinopathy

 -  Spinal anaesthetic not possible