Comparison of intraoperative surgical field visualization between the use of a tourniquet and without a tourniquet in primary total knee arthroplasty : a randomized controlled, non-inferiority trial

INTERVENTION: All patients have their thighs covered with a tourniquet. Inflate or deflate based on the assigned group. the tourniquet will not be inflated for patients in the non tourniquet group (Without tourniquet TKA).,All patients have their thighs covered with a tourniquet. Inflate or deflate based on the assigned group. Operating room personnel will inflate the tourniquet (Zimmer ATS 4000) to the Recommended Tourniquet Pressure (RTP), which is determined preoperatively using an LOP (Limb Occlusion Pressure) sensor kit. The RTP is calculated based on each individual patient's blood pressure and thigh circumference. This procedure will be performed for patients in the tourniquet group (Tourniquet TKA). Experimental Procedure/Surgery,Experimental Procedure/Surgery Without tourniquet TKA,Tourniquet TKA CONDITION: Intraoperative surgical field visualization score between tourniquet and without a tourniquet in primary total knee arthroplasty ; intraoperative surgical field visualization score, surgical field visualization score, field visualization score, visualization score, tourniquet, without a tourniquet, non tourniquet, without tourniquet, TKA, primary total knee arthroplasty, total knee arthroplasty, total knee replacement intraoperative surgical field visualization score, surgical field visualization score, field visualization score, visualization score, tourniquet, without a tourniquet, non tourniquet, without tourniquet, TKA, primary total knee arthroplasty, total knee arthroplasty, total knee replacement PRIMARY OUTCOME: Intraoperative surgical field visualization score At the end of operation Category scale adapted from Fromme and Boezaart et al SECONDARY OUTCOME: Postoperative pain score 24 hours and 72 hours after TKA Verbal numerical pain score,Leg circumference at Day 72 hours after TKA Measure thigh (10 cm proximal to the superior border of the patella), knee (midpoint of the patella), and calf (20 cm proximal to the medial malleolus) circumference in centimeters,Incidence of wound complications and thigh ecchymosis During hospitalization Wound grading according to the Southampton Scoring System and observation of thigh ecchymosis,Total blood loss Before surgery and 48 hours after TKA Measured by Gross formula use hematocrit INCLUSION CRITERIA: 1.Patients aged between 55‐80 years 2.Patients diagnosed with primary osteoarthritis of the knee 3.Patients who admitted for primary unilateral TKA at our institution