Tourniquet use in total knee arthroplasty: a meta-analysis
Open Access
- 15 December 2010
- journal article
- research article
- Published by Wiley in Knee Surgery, Sports Traumatology, Arthroscopy
- Vol. 19 (7), 1121-1130
- https://doi.org/10.1007/s00167-010-1342-7
Abstract
Purpose The use of an intraoperative tourniquet for total knee arthroplasty (TKA) is a common practice. However, the effectiveness and safety are still questionable. A systematic review was conducted to examine that whether using a tourniquet in TKA was effective without increasing the risk of complications. Methods A comprehensive literature search was done in PubMed Medicine, Embase, and other internet database. The review work and the following meta-analysis were processed to evaluate the role of tourniquet in TKA. Results Eight randomized controlled trials and three high-quality prospective studies involving 634 knees and comparing TKA with and without the use of a tourniquet were included in this analysis. The results demonstrated that using a tourniquet could decrease the measured blood loss but could not decrease the calculated blood loss, which indicated actual blood loss. Patients managed with a tourniquet might have higher risks of thromboembolic complications. Using the tourniquet with late release after wound closure could shorten the operation time; whereas early release did not show this benefit. Conclusions The current evidence suggested that using tourniquet in TKA may save time but may not reduce the blood loss. Due to the higher risks of thromboembolic complications, we should use a tourniquet in TKA with caution.Keywords
This publication has 40 references indexed in Scilit:
- Efficient strategy for controlling postoperative hemorrhage in total knee arthroplastyKnee Surgery, Sports Traumatology, Arthroscopy, 2010
- Conventional drainage versus four hour clamping drainage after total knee arthroplasty in severe osteoarthritis: a prospective, randomised trialInternational Orthopaedics, 2008
- The effect of tourniquet use on hidden blood loss in total knee arthroplastyInternational Orthopaedics, 2008
- Anesthetic, Patient, and Surgical Risk Factors for Neurologic Complications After Prolonged Total Tourniquet Time During Total Knee ArthroplastyAnesthesia & Analgesia, 2006
- Changes in coagulation‐fibrinolysis marker and neutrophil elastase following the use of tourniquet during total knee arthroplasty and the influence of neutrophil elastase on thromboembolismActa Anaesthesiologica Scandinavica, 2005
- Measuring inconsistency in meta-analysesBMJ, 2003
- The tourniquet in total knee arthroplastyThe Journal of Bone and Joint Surgery. British volume, 1999
- Meta-analysis in clinical trialsControlled Clinical Trials, 1986
- Estimating Allowable Blood LossAnesthesiology, 1983
- Early Biochemical and Hemodynamic Changes after Operation in a Bloodless FieldEuropean Surgical Research, 1977