To prospectively evaluate the postoperative hemostatic effect of using tourniquet with different way during total knee arthroplasty(TKA) in patients with high coagulation condition.

In the prospective study, 92 cases of patients received TKA with different tourniquet applications were enrolled (D-Dimer>1 000 μg/L) and randomly divided into group A (half-course group, n=46) using tourniquet only during cementation and group B (whole-course group, n=46) using tourniquet from incision to wound closure. The operation duration, wound drainage, hidden blood loss, total blood loss, hemoglobin loss, blood transfusion rate, average transfusion volume, pain score, range of motion, limb-swelling and complication were recorded and analyzed by t test and χ² test using SPSS 19.0.

The wound drainage, hidden blood loss, total blood loss, hemoglobin loss, pain score, limb-swelling and complications in group A were significantly lower than those in group B(t=-7.432, -15.72, -2.205, -2.746, -3.070, -5.525, all P<0.05). The operation duration and range of motion were significantly higher in group A than those in group B(t=8.098, 2.290, both P<0.05), there was no significant difference in blood transfusion rate and average transfusion volume between two groups(χ²=0.956, t=-0.329, both P>0.05).

Using half-course tourniquet has a better hemostatic effect and a lower complication suffering rate than using whole-course tourniquet after TKA in the patients with high coagulation condition.