SynthesisJournal of orthopaedic surgery and research2014
The effects of a tourniquet used in total knee arthroplasty: a meta-analysis.
Synthesis in Journal of orthopaedic surgery and research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 120 papers, 12 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effect of Tourniquet Time and Pressure on Intraoperative and Postoperative Performance, Function, Pain, and Complications in Primary Total Knee Arthroplasty.
Efficacy Testing of Different Tourniquet Pressure Used for Postoperative Pain Reduction in Total Knee Arthroplasty: A Prospective, Randomized Controlled Trials
Blood Loss Assessment in the Limited Application of Tourniquet During Primary Unilateral TKA: a Randomized Controlled Study
Does Tourniquet Utilization Negatively Impact Patient Pain and Outcomes Following Operative Fixation of Rotational Ankle Fractures? A Randomized Clinical Trial.
Who cites it
120 citing papers in PubMed, 12 syntheses or guidelines pooled it, 246 citations in OpenAlex.
- Total knee arthroplasty with or without a tourniquet: a meta-analysis of randomized controlled trials.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Pooled it
- Pharmacological interventions for the prevention of bleeding in people undergoing elective hip or knee surgery: a systematic review and network meta-analysis.The Cochrane database of systematic reviews · 2024Pooled it
- Impact of tourniquet during total knee arthroplasty when tranexamic acid was used: a meta-analysis of randomized controlled trials.Journal of orthopaedic surgery and research · 2022Pooled it
- The risks associated with tourniquet use in lower limb trauma surgery: a systematic review and meta-analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2021Pooled it
- Time to reconsider the routine use of tourniquets in total knee arthroplasty surgery.The bone & joint journal · 2021Pooled it
- Tourniquet use for knee replacement surgery.The Cochrane database of systematic reviews · 2020Pooled it
- More pain and slower functional recovery when a tourniquet is used during total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Pooled it
- The effects of tourniquet use on blood loss in primary total knee arthroplasty for patients with osteoarthritis: a meta-analysis.Journal of orthopaedic surgery and research · 2019Pooled it
- Does Tourniquet Use in TKA Increase Postoperative Pain? A Systematic Review and Meta-analysis.Clinical orthopaedics and related research · 2019Pooled it
- Pooled it
- Tourniquet use in lower limb fracture surgery: a systematic review and meta-analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2019Pooled it
- Effects of the timing of tourniquet release in cemented total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials.Journal of orthopaedic surgery and research · 2014Pooled it
- Effects of special waterproof layer under tourniquet cuff on the incidence of burns and pain intensity and satisfaction of operating room staff in knee arthroscopic surgeries: a randomized clinical trial.Journal of orthopaedic surgery and research · 2025Trial
- Optimizing surgical field visualization in total knee arthroplasty: a randomized controlled trial comparing esmarch bandages and simple leg elevation.Journal of orthopaedic surgery and research · 2025Trial
- Trial
- Tourniquet Effect on Patients Undergoing Total Knee Arthroplasty: A Single-Blind, Randomized Controlled Trial.Orthopaedic surgery · 2024Trial
- The use of tourniquet in total knee arthroplasty does not impact the functional outcome: a randomised controlled study.Journal of orthopaedic surgery and research · 2024Trial
- With or without a Tourniquet? A Comparative Study on Total Knee Replacement Surgery in Patients without Comorbidities.Medicina (Kaunas, Lithuania) · 2023Trial
- The Impact of Tourniquet Usage on TKA Outcome: A Single-Center Prospective Trial.Medicina (Kaunas, Lithuania) · 2023Trial
- Risk factor of postoperative incision infection after plate internal fixation of calcaneal fractures: a retrospective study.BMC musculoskeletal disorders · 2022Trial
60 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe purpose of this research is to evaluate the effects of a tourniquet in total knee arthroplasty (TKA).
methodsThe study was done by randomized controlled trials (RCTs) on the effects of a tourniquet in TKA. All related articles which were published up to June 2013 from Medline, Embase, and Cochrane Central Register of Controlled Trails were identified. The methodological quality of the included studies was assessed by the Physiotherapy Evidence Database (PEDro) scale. The meta-analysis was performed using Cochrane RevMan software version 5.1.
resultsThirteen RCTs that involved a total of 689 patients with 689 knees were included in the meta-analysis, which were divided into two groups. The tourniquet group included 351 knees and the non-tourniquet group included 338 knees. The meta-analysis showed that using a tourniquet in TKA could reduce intraoperative blood loss (weighted mean difference (WMD), -198.21; 95% confidence interval (CI), -279.82 to -116.60; P<0.01) but did not decrease the calculated blood loss (P=0.80), which indicates the actual blood loss. Although TKA with a tourniquet could save the operation time for 4.57 min compared to TKA without a tourniquet (WMD, -4.57; 95% CI, -7.59 to -1.56; P<0.01), it had no clinical significance. Meanwhile, the use of tourniquet could not reduce the possibility of blood transfusion (P>0.05). Postoperative knee range of motion (ROM) in tourniquet group was 10.41° less than that in the non-tourniquet group in early stage (≤ 10 days after surgery) (WMD, -10.41; 95% CI, -16.41 to -4.41; P<0.01). Moreover, the use of a tourniquet increased the risk of either thrombotic events (risk ratio (RR), 5.00; 95% CI, 1.31 to 19.10; P=0.02) or non-thrombotic complications (RR, 2.03; 95% CI, 1.12 to 3.67; P=0.02).
conclusionsTKA without a tourniquet was superior to TKA with a tourniquet in thromboembolic events and the other related complications. There were no significant differences between the two groups in the actual blood loss. TKA with a tourniquet might hinder patients' early postoperative rehabilitation exercises.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.