Tourniquet use in total knee arthroplasty: A meta-analysis

Research output: Contribution to journalReview article

117 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1121-1130
Number of pages10
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume19
Issue number7
DOIs
Publication statusPublished - 2011 Jul 1

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Tourniquets
Knee Replacement Arthroplasties
Meta-Analysis
PubMed
Internet
Knee
Randomized Controlled Trials
Medicine
Databases
Prospective Studies
Safety

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

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title = "Tourniquet use in total knee arthroplasty: A meta-analysis",
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.",
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Tourniquet use in total knee arthroplasty : A meta-analysis. / Tai, Ta Wei; Lin, Chii Jeng; Jou, I. Ming; Chang, Chih Wei; Lai, Kuo An; Yang, Chyun Yu.

In: Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 19, No. 7, 01.07.2011, p. 1121-1130.

Research output: Contribution to journalReview article

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