Evidence map›Paper›PMID 25248311›Full record

Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2016

Influence of the tourniquet on tibial cement mantle thickness in primary total knee arthroplasty.

Tilman Pfitzner, Philipp von Roth, Ninja Voerkelius, Hermann Mayr, Carsten Perka, Robert Hube

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
49citing papers in PubMed, 9 pooled it
2.3field-weighted citation impact, top 12% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

49 citing papers in PubMed, 9 syntheses or guidelines pooled it, 95 citations in OpenAlex.

  1. Total knee arthroplasty with or without a tourniquet: a meta-analysis of randomized controlled trials.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
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  7. Tourniquet use for knee replacement surgery.The Cochrane database of systematic reviews · 2020
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  8. 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 · 2020
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  15. Tourniquet application does not affect the periprosthetic bone cement penetration in total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019
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  19. After early release of tourniquet in total knee arthroplasty, should it be reinflated or kept deflated? A randomized trial.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2017
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Tilman PfitznerOrthopaedic Department, Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. Tilman.pfitzner@charite.de.
Philipp von RothOrthopaedic Department, Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Ninja VoerkeliusOrthopädische Chirurgie München, Steinerstraße 6, 81369, Munich, Germany.
Hermann MayrOrthopädische Chirurgie München, Steinerstraße 6, 81369, Munich, Germany.
Carsten PerkaOrthopaedic Department, Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Robert HubeOrthopädische Chirurgie München, Steinerstraße 6, 81369, Munich, Germany.
Charité - Universitätsmedizin Berlin · DEOrthopädische Praxis · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe purpose of the study was whether the use of a tourniquet increases cement mantle thickness in primary total knee arthroplasty and influences the calculated blood loss and postoperative pain.

methodsNinety patients with a primary total knee arthroplasty (TKA) were enroled in this prospective randomised trial and divided into a group with (n = 45) and without tourniquet (n = 45). The radiological tibial cement mantle thickness was evaluated postoperatively in four zones on anteroposterior and two zones on lateral radiographs, and values were cumulated. Additionally, the calculated blood loss and postoperative pain levels were recorded.

resultsThere was a median cumulative cement mantle thickness of 13 mm (range 8-19 mm) without tourniquet and of 14.2 mm (range 9-18 mm) with tourniquet (p = 0.009). The median calculated blood loss was 0.6 L (range 0.2-2.0 L) without and 0.9 L (range 0.3-1.5 L) (p = 0.02) with tourniquet. Patient-reported postoperative pain levels were significantly higher in the tourniquet group during mobilisation (p = 0.01) and at rest (p = 0.001).

conclusionsThe use of a tourniquet in primary TKA increased the tibial cement mantle thickness but also increased the postoperative calculated blood loss and postoperative pain. Surgeons might take this into consideration for decision-making whether to use a tourniquet during TKA. LEVEL OF EVIDENCE: II.

Indexed as

Arthroplasty, Replacement, KneeTourniquetsAgedAged, 80 and overBlood Loss, SurgicalBone CementsCementationFemaleHumansMaleMiddle AgedOsteoarthritis, KneePostoperative HemorrhagePostoperative PainProspective StudiesRadiographyBone CementsBlood lossCementing techniqueCement mantle thicknessTotal knee arthroplastyTourniquet

Identifiers

PMID25248311
OpenAlexW2050114784

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.