International Master’s Anterior Course (Imacx)
Wisconsin Ortho Society (WOS) Annual Conference
Arthroplasty for the Modern Surgeon CME Conference
2026 South Carolina Orthopedic Association (SCOA) Annual Meeting
American Association of Hip & Knee Surgeons (AAHKS) 2026 Annual Meeting
American Orthopedic Society for Sports Medicine (AOSSM) 2026 Annual Meeting
IOEN Rochester Revision Course
AAOS 2027 Annual Meeting
Reducing Opiate Use: The Tourniquetless TKA
Tourniquetless TKA with CarboJet Reduces Opioid Consumption
Orlando, Florida (December 2017) – A new study demonstrates reduced opioid consumption in female patients when a tourniquet was not used in total knee arthroplasty (TKA). The study was conducted by R. Michael Meneghini, M.D, of the Indiana University School of Medicine and presented at the 34th Annual Current Concepts in Joint Replacement (CCJR) Winter Meeting. The CarboJet® bone preparation system was used to maximize cement interdigitation in tourniquetless knees. CarboJet has been widely adopted wherever cemented implant fixation is employed, including in tourniquet-free TKA. Tourniquet-free TKA, also referred to as “No Tourniquet TKA,” “Tourniquet-less TKA,” and “TKA Sans Tourniquet,” has been shown to offer many benefits over traditional TKA with a tourniquet. The ability to reduce opioid consumption using this technique is significant, since opioid addiction has become a national crisis and protocols that result in reduced patient pain are highly sought after.
Reducing Opiate Use: The Tourniquetless TKA
R. Michael Meneghini, M.D.
Director of Joint Replacement – IU Health Saxony Hospital
Associate Professor of Orthopaedic Surgery
Indiana University School of Medicine Indianapolis, Indiana, USA
Introduction: Tourniquet use in total knee arthroplasty (TKA) remains controversial and few reports exist using contemporary pain protocols and tranexamic acid (TXA). This study aimed to examine whether a modern TKA protocol without a tourniquet results in less blood loss, patient-reported pain, and opioid consumption compared to TKAs with a tourniquet.
Methods: A retrospective study was performed on 210 consecutive primary cemented TKAs using computer-assisted navigation with or without tourniquet. The tourniquet was inflated the entire procedure or not at all, and sterile CO2 gas was used to maximize cement interdigitation in non-tourniquet knees. All patients received identical implants and underwent the same TKA peri-operative protocols. Standardized inpatient pain level targets were utilized and medication titrated to control post-operative pain. Pain on a 10 point scale in the first 24 hours after surgery and blood loss (pre-operative to post-operative day 1 decline on hemoglobin, total blood loss in liters, drain output in milliliters, and drain output per hour) were analyzed relative to tourniquet use.
Results: After exclusions for confounds, 184 consecutive TKAs (93 tourniquet; 91 tourniquetless) were analyzed. Age (p = 0.561) and BMI (p = 0.580) did not differ between the two groups. By chance, there were significantly more females in the tourniquet group (55.9%) compared to the no tourniquet group (44.1%) (p = 0.019). Consequently, outcome analyses were performed separately for females and males. Median pain in the first 24 hours was significantly lower for women without a tourniquet (1.9 vs. 2.7, p = 0.002). This corresponded to significantly less opioid consumption in the first 24 hours among women without tourniquets (18.8 vs. 42.8 Me, p < 0.0001). Neither pain nor opioid consumption in the first 24 hours differed based on tourniquet use in men (p ≥ 0.114). Not surprisingly, significantly more blood loss was observed on all four metrics in tourniquetless knees for both women (p ≤ 0.040) and men (p ≤ 0.020).
Discussion: In contemporary TKA using multi-modal pain protocols and TXA, not using a tourniquet resulted in less pain and lower narcotic consumption in the first 24 hours after surgery for women, but not for men. It is possible that women may be more effected by tourniquet-induced ischemia in the early post-operative period. These results are timely with current national initiatives to minimize peri-operative opioid consumption.
Presented at the Winter 2017 Current Concepts in Joint Replacement Meeting in Orlando, FL, USA
Kinamed Names Executives to Lead Global Sales and Marketing Strategy
Camarillo CA, (September 19, 2016) – Kinamed Incorporated announced today that it has appointed Roy Fiebiger as Vice President of Global Sales, and Bob Bruce as Vice President of Global Marketing & Product Strategy. Mr. Fiebiger and Mr. Bruce will each report to Kinamed President Vineet Sarin, PhD.
Mr. Fiebiger’s role reflects Kinamed’s long-term strategy to target top-line growth by focusing on geographic expansion and deeper market penetration in all regions. As VP of Global Sales, Mr. Fiebiger will lead Kinamed’s global commercialization network, regional sales management, forecasting, sales strategy, and customer sales support.
“Roy is a proven leader who brings significant global commercialization experience to the role and understands all aspects of our business,” Dr. Sarin said. “Under his leadership, we will strengthen our commercialization strategies and bring new ideas and energy to our commercialization partners.”
Mr. Fiebiger has more than 25 years of medical device and orthopaedic product commercialization experience. Mr. Fiebiger joined Kinamed in 2013 and most recently served as its Vice President of International Sales & Business Development. Prior to joining Kinamed, Mr. Fiebiger held executive leadership positions with NeuColl, Laserscope, Norian, Techmedica, and Johnson & Johnson. While at Kinamed, Mr. Fiebiger has helped to significantly expand its international presence.
Bob Bruce’s new role reflects Kinamed’s focus on the promotion of existing and new products in both established and new markets throughout the world. Mr. Bruce began leading Kinamed’s sales and marketing efforts in 1996 as its Director of Marketing and later as its Vice President of Sales & Marketing, and served as its Vice President of Global Sales & Marketing since 2013. Prior to joining Kinamed, Mr. Bruce held key technical and product management positions with The Anspach Effort and Techmedica.
Throughout his successful tenure at Kinamed, Mr. Bruce has played a leading role in the development, launch, and market expansion of all of the company’s major product lines.
Kinamed is eager to explore and develop a number of new product applications and proprietary technologies in its portfolio. “We are delighted to have someone with Bob’s experience, skill, tenacity, and leadership in this key position”, Dr. Sarin said. “Bob will spearhead Kinamed’s marketing and product strategies by working closely with clinicians, our channel partners, and our product development team to define and deliver compelling solutions to customers in the United States and throughout the world.”
About Kinamed
Established in 1987, Kinamed is a privately held designer and manufacturer of implants and surgical instruments. Kinamed’s products include: The flagship SuperCable® Iso-Elastic™ Cerclage System: a non-metallic, iso-elastic cerclage system that solves many of the inherent problems associated with traditional wire and cable cerclage; the CarboJet® Carbon Dioxide Bone Preparation System: a proprietary device for cleaning and preparing bone surfaces during orthopedic procedures; the KineMatch® Patello-Femoral Replacement: a custom unicompartmental (partial) joint replacement designed specifically for patients with isolated, end-stage patello-femoral disease; the NeuroPro® Cranial Plating System; and the NaviPro® Surgical Navigation System. Kinamed products are sold throughout the United States and in over 30 international markets through a network of independent distributors and sales agencies.
To learn more about Kinamed, please visit www.Kinamed.com
Contact
Vineet K. Sarin, Ph.D.
President
Kinamed, Inc.