SynthesisJournal of orthopaedic surgery and research2014
Effects of the timing of tourniquet release in cemented total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials.
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. Cited by 24 papers, 5 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 5 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- The impact of tourniquet on tibial bone cement penetration in different zones in primary total knee arthroplasty: a meta-analysis.Journal of orthopaedic surgery and research · 2021Pooled 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
- Pooled it
- Comparison of the effectiveness and safety of topical versus intravenous tranexamic acid in primary total knee arthroplasty: a meta-analysis of randomized controlled trials.Journal of orthopaedic surgery and research · 2017Pooled it
- The effects of tourniquet use on blood loss and perioperative complications in total knee arthroplasty.BMC musculoskeletal disorders · 2023Trial
- Lower tourniquet pressure does not affect pain nor knee-extension strength in patients after total knee arthroplasty: a randomized controlled trial.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Trial
- The effect of tourniquet usage on cement penetration in total knee arthroplasty: A prospective randomized study of 3 methods.Medicine · 2018Trial
- Effects of different methods of using pneumatic tourniquet in patients undergoing total knee arthroplasty: a randomized control trial.Irish journal of medical science · 2017Trial
- Cementless vs. Cemented Total Knee Arthroplasty: Reduced Operative Time with Comparable Perioperative Safety-A Retrospective Cohort from a Tertiary Care Center.Journal of clinical medicine · 2025Article
- Article
- Limiting tourniquet use during total knee arthroplasty improves short-term postoperative outcomes in patients with hypertension.Frontiers in surgery · 2025Article
- Role of tourniquet release timing on blood loss and functional outcomes in total knee arthroplasty: Insights from a low- and middle-income country.Journal of experimental orthopaedics · 2024Article
- The mid-term and long-term effects of tourniquet use in total knee arthroplasty: systematic review.Journal of experimental orthopaedics · 2022Review
- [Perioperative blood management for total hip/knee arthroplasty].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2020Article
- Tibial cement mantle thickness is not affected by tourniquetless total knee arthroplasty when performed with tranexamic acid.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
- Do tourniquet and drainage influence fast track in total knee arthroplasty? Our results on 151 cases.Acta bio-medica : Atenei Parmensis · 2019Article
- Optimizing Intraoperative Blood Management for One-Stage Bilateral Total Knee Arthroplasty.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2018Review
- Soft-tissue damage during total knee arthroplasty: Focus on tourniquet-induced metabolic and ionic muscle impairment.Journal of orthopaedics · 2017Review
- Different patient satisfaction levels between the first and second knee in the early stage after simultaneous bilateral total knee arthroplasty (TKA): a comparison between subjective and objective outcome assessments.Journal of orthopaedic surgery and research · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of this study is to evaluate the effects of tourniquet release before wound closure for hemostasis or after wound closure in cemented total knee arthroplasty (TKA).
methodsWe conducted a meta-analysis and review work on relevant clinical outcomes to evaluate the effects of the timing of tourniquet release in cemented TKA. Electronic databases were searched for relevant randomized controlled trials (RCTs) that compared outcomes of tourniquet release before wound closure for hemostasis with tourniquet release after wound closure. The methodological quality of each included RCT was assessed in terms of the 12-item scale. The meta-analysis was performed with STATA 12.0 software.
resultsEleven RCTs involving 651 patients with 670 TKAs were included in this meta-analysis. Of these, 332 patients (342 knees) were in an early tourniquet release group and 319 patients (328 knees) in the late tourniquet release group. The results showed that there were no significant differences in overt blood loss, hemoglobin drop, and blood transfusions, whereas the tourniquet release after wound closure might increase the risks of overall complications and major complications.
conclusionsTourniquet release before wound closure for hemostasis might reduce the rate of complications, but it could not limit overall blood loss. The current evidences are not enough to indicate that tourniquet release before wound closure is superior to its release after wound closure in cemented TKA.
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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.