Sharp dissection versus monopolar electrocautery in primary TKR
Research type
Research Study
Full title
Sharp dissection versus monopolar electrocautery in primary total knee arthroplasty performed under tourniquet: a randomized double blind controlled trial
IRAS ID
244896
Contact name
Chloe Scott
Contact email
Sponsor organisation
NHS Lothian
Clinicaltrials.gov Identifier
Duration of Study in the UK
2 years, 6 months, 1 days
Research summary
The approach to the knee to carry out a total knee arthroplasty (TKA) can either be carried out using a scalpel (sharp dissection), or using an electric current to divide tissue (monopolar electocautery, diathermy). Reducing blood loss is important. Bloods 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, a cuff 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.
This study plans to compare the use of a scalpel and diathermy in the aforementioned ways. Patients will be recruited from pre-assesment clinics a few weeks prior to their surgery date and randomised to one of the two methods of approach. Patients will receive routine care post TKA in every way apart from additional formal range of motion and pain assessments as an inpatient and outpatient. They will not require additional outpatient review compared to the standard patient pathway.
REC name
South East Scotland REC 01
REC reference
19/SS/0007
Date of REC Opinion
16 Jan 2019
REC opinion
Favourable Opinion