Abstract: Objective To investigate the effects of different tourniquet release modes in the elderly patients undergoing total knee arthroplasty (TKA) and optimize the application scheme of tourniquets. Methods Ninety-three elderly patients who would undergo unilateral TKA in Department of Orthopedics, Luhe People’s Hospital of Nanjing, from 2019 to 2021 were selected, and they were randomly divided into 3 groups: Group A (receiving full duration of tourniquet application and routine release), Group B (receiving half duration of tourniquet application and routine release) and Group C (receiving half duration of tourniquet application and staged release), with 31 cases in each group. The operation time, blood loss volume, postoperative visual analogue scale (VAS) scores, knee joint range of motion (ROM) and the incidence of complications were compared among the three groups. Results There was no significant difference in operation time among the three groups (P>0.05). Compared with Group C, the intraoperative blood loss, hidden blood loss and total blood loss were lower in Group A, but higher in Group B; the postoperative drainage volume was higher in Group A and B (P<0.05). On the 1st, 7th, and 14th day after surgery, the VAS scores in Group C were lower than those in Group A and B (P<0.05); On the 7th and 14th day after surgery, the level of ROM in Group C was higher than that in Group A and B (P<0.05). There were no differences in the incidence rates of skin blisters, incision seepage, and deep vein thrombosis among the three groups, but the total incidence rate of complications in Group C was lower than that in Group A and B (P<0.05). Conclusions Compared with conventional release mode of tourniquet during TKA, half duration of tourniquet application and staged release can reduce the postoperative pain, increase the knee ROM, and promote early recovery in the elderly patients.

Key words: aged, personalized, tourniquet release, total knee arthroplasty