Safety and feasibility of preoperative non-indwelling catheter in primary unilateral total knee arthroplasty without tourniquet_West China Medical Journal

Authors：

LUO Qiuping ¹ , WANG Juan ¹ ,  YANG Jing ²

1. Outpatient Department, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

YANG Jing, Email: cd-yangjing@163.com

Keywords：

Tourniquet; Indwelling catheter; Total knee arthroplasty

DOI：

10.7507/1002-0179.201703122

Video：

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Objective To investigate the safety and feasibility of preoperative non-indwelling catheter in primary unilateral total knee arthroplasty (TKA) without tourniquet . Methods From January 2016 to January 2017, a total of 60 patients undergoing primary unilateral TKA surgery were randomly divided into preoperative non-indwelling catheter group (group NIC, n=30) and indwelling catheter group (group IC, n=30) . The patients in group NIC were not retained catherter, and the patients in group IC were retained catherter. All patients did not use tourniquet. The time of first urination, the volume of first urination, and the occurrence of urine retention, urinary irritation symptoms and urinary tract infection of patients in two groups were analyzed. The incidence of venous thrombosis of the lower extremity was also recorded. Results There were statistical differences (P<0.05) between group NIC and group IC in the time of first urination [(3.2±0.6) vs. (4.5±1.8) hours] and urine volume [(262.5±29.4) vs. (391.6±50.2) mL], but there was no significant difference (P>0.05) between the two groups in urinary retention (6.7% vs. 16.7%), urinary tract irritation (33.3% vs. 23.3%), or urinary tract infection (0.0% vs. 16.7%). Conclusion Preoperative non-indwelling catheter in primary unilateral TKA without tourniquet is safe and feasible.

Citation： LUO Qiuping, WANG Juan, YANG Jing. Safety and feasibility of preoperative non-indwelling catheter in primary unilateral total knee arthroplasty without tourniquet. West China Medical Journal, 2017, 32(7): 1060-1063. doi: 10.7507/1002-0179.201703122 Copy

1.	Sabatini L, Atzori F, Revello S, et al. Intravenous use of tranexamic acid reduces postoperative blood loss in total knee arthroplasty. Arch Orthop Trauma Surg, 2014, 134(11): 1609-1614.
2.	Martin JG, Cassatt KB, Kincaid-Cinnamon KA, et al. Topical administration of tranexamic acid in primary total hip and total knee arthroplasty. J Arthroplasty, 2014, 29(5): 889-894.
3.	Balderi T, Carli F. Urinary retention after total hip and knee arthroplasty. Minerva Anestesiol, 2010, 76(2): 120-130.
4.	Berbari EF, Hanssen AD, Duffy MC, et al. Risk factors for prosthetic joint infection: case-control study. Clin Infect Dis, 1998, 27(5): 1247-1254.
5.	Karason S, Olafsson TA. Avoiding bladder catheterisation in total knee arthroplasty: patient selection criteria and low-dose spinal anaesthesia. Acta Anaesthesiol Scand, 2013, 57(5): 639-645.
6.	Huang ZY, Ma J, Shen B, et al. General anesthesia: to catheterize or not? A prospective randomized controlled study of patients undergoing total knee arthroplasty. J Arthroplasty, 2015, 30(3): 502-506.
7.	蔡东峰, 马俊, 黄泽宇, 等. 静脉联合吸入麻醉下不导尿全膝关节置换术安全性及有效性分析. 国际骨科学杂志, 2014, 35(5): 337-340.
8.	Balderi T, Mistraletti G, D’angelo E, et al. Incidence of postoperative urinary retention (POUR) after joint arthroplasty and management using ultrasound-guided bladder catheterization. Minerva Anestesiol, 2011, 77(11): 1050-1057.
9.	中华医学会骨科学分会. 中国骨科大手术静脉血栓栓塞症预防指南. 中华关节外科杂志: 电子版, 2009, 29(6): 602-604.
10.	Russell RD, Huo MH. Apixaban and rivaroxaban decrease deep venous thrombosis but not other complications after total hip and total knee arthroplasty. J Arthroplasty, 2013, 28(9): 1477-1481.
11.	Goodnough LT, Verbrugge D, Marcus RE. The relationship between hematocrit, blood lost, and blood transfused in total knee replacement. Implications for postoperative blood salvage and reinfusion. Am J Knee Surg, 1995, 8(3): 83-87.
12.	Bong MR, Patel V, Chang E, et al. Risks associated with blood transfusion after total knee arthroplasty. J Arthroplasty, 2004, 19(3): 281-287.
13.	Şükür E, Öztürkmen Y, Akman YE, et al. The effect of tourniquet and knee position during wound closure after total knee arthroplasty on early recovery of range of motion: a prospective, randomized study. Arch Orthop Trauma Surg, 2016, 136(12): 1773-1780.
14.	Wang K, Ni SJ, Li ZC, et al. The effects of tourniquet use in total knee arthroplasty: a randomized, controlled trial. Knee Surg Sports Traumatol Arthrosc, 2016, 1-9.
15.	Knight RM, Pellegrini VD. Bladder management after total joint arthroplasty. J Arthroplasty, 1996, 11(8): 882-888.
16.	Miller AG, Mckenzie J, Greenky M, et al. Spinal anesthesia: should everyone receive a urinary catheter? A randomized, prospective study of patients undergoing total hip arthroplasty. J Bone Joint Surg Am, 2013, 95(16): 1498-1503.
17.	文守琴, 李玲利, 陈佳丽, 等. 全膝关节置换术不安置尿管的可行性研究. 华西医学, 2014, 29(12): 2342-2343.
18.	杨小春. 全膝关节置换术髌骨置换疗效的研究. 宁夏: 宁夏医科大学, 2013.
19.	张捷, 徐梅, 王英丽, 等. 留置导尿对全麻单侧膝关节置换术患者尿路刺激症状的影响. 中华现代护理杂志, 2016, 22(27): 3951-3953.

1. Sabatini L, Atzori F, Revello S, et al. Intravenous use of tranexamic acid reduces postoperative blood loss in total knee arthroplasty. Arch Orthop Trauma Surg, 2014, 134(11): 1609-1614.
2. Martin JG, Cassatt KB, Kincaid-Cinnamon KA, et al. Topical administration of tranexamic acid in primary total hip and total knee arthroplasty. J Arthroplasty, 2014, 29(5): 889-894.
3. Balderi T, Carli F. Urinary retention after total hip and knee arthroplasty. Minerva Anestesiol, 2010, 76(2): 120-130.
4. Berbari EF, Hanssen AD, Duffy MC, et al. Risk factors for prosthetic joint infection: case-control study. Clin Infect Dis, 1998, 27(5): 1247-1254.
5. Karason S, Olafsson TA. Avoiding bladder catheterisation in total knee arthroplasty: patient selection criteria and low-dose spinal anaesthesia. Acta Anaesthesiol Scand, 2013, 57(5): 639-645.
6. Huang ZY, Ma J, Shen B, et al. General anesthesia: to catheterize or not? A prospective randomized controlled study of patients undergoing total knee arthroplasty. J Arthroplasty, 2015, 30(3): 502-506.
7. 蔡东峰, 马俊, 黄泽宇, 等. 静脉联合吸入麻醉下不导尿全膝关节置换术安全性及有效性分析. 国际骨科学杂志, 2014, 35(5): 337-340.
8. Balderi T, Mistraletti G, D’angelo E, et al. Incidence of postoperative urinary retention (POUR) after joint arthroplasty and management using ultrasound-guided bladder catheterization. Minerva Anestesiol, 2011, 77(11): 1050-1057.
9. 中华医学会骨科学分会. 中国骨科大手术静脉血栓栓塞症预防指南. 中华关节外科杂志: 电子版, 2009, 29(6): 602-604.
10. Russell RD, Huo MH. Apixaban and rivaroxaban decrease deep venous thrombosis but not other complications after total hip and total knee arthroplasty. J Arthroplasty, 2013, 28(9): 1477-1481.
11. Goodnough LT, Verbrugge D, Marcus RE. The relationship between hematocrit, blood lost, and blood transfused in total knee replacement. Implications for postoperative blood salvage and reinfusion. Am J Knee Surg, 1995, 8(3): 83-87.
12. Bong MR, Patel V, Chang E, et al. Risks associated with blood transfusion after total knee arthroplasty. J Arthroplasty, 2004, 19(3): 281-287.
13. Şükür E, Öztürkmen Y, Akman YE, et al. The effect of tourniquet and knee position during wound closure after total knee arthroplasty on early recovery of range of motion: a prospective, randomized study. Arch Orthop Trauma Surg, 2016, 136(12): 1773-1780.
14. Wang K, Ni SJ, Li ZC, et al. The effects of tourniquet use in total knee arthroplasty: a randomized, controlled trial. Knee Surg Sports Traumatol Arthrosc, 2016, 1-9.
15. Knight RM, Pellegrini VD. Bladder management after total joint arthroplasty. J Arthroplasty, 1996, 11(8): 882-888.
16. Miller AG, Mckenzie J, Greenky M, et al. Spinal anesthesia: should everyone receive a urinary catheter? A randomized, prospective study of patients undergoing total hip arthroplasty. J Bone Joint Surg Am, 2013, 95(16): 1498-1503.
17. 文守琴, 李玲利, 陈佳丽, 等. 全膝关节置换术不安置尿管的可行性研究. 华西医学, 2014, 29(12): 2342-2343.
18. 杨小春. 全膝关节置换术髌骨置换疗效的研究. 宁夏: 宁夏医科大学, 2013.
19. 张捷, 徐梅, 王英丽, 等. 留置导尿对全麻单侧膝关节置换术患者尿路刺激症状的影响. 中华现代护理杂志, 2016, 22(27): 3951-3953.

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Safety and feasibility of preoperative non-indwelling catheter in primary unilateral total knee arthroplasty without tourniquet

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