Evidence map›Paper›PMID 25505702›Full record

ArticleKnee surgery & related research2014

Effects of tourniquet use on quadriceps function and pain in total knee arthroplasty.

David Liu, David Graham, Kim Gillies, R Mark Gillies

3 registry-linked trialsOpen access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Knee surgery & related research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 65 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
65citing papers in PubMed, 11 pooled it
7.0field-weighted citation impact, top 3% 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.

NCT02830087 naterminatednot on this mapstarted 2016, after this paper: background citation

The Effect of Tourniquet Time and Pressure on Intraoperative and Postoperative Performance, Function, Pain, and Complications in Primary Total Knee Arthroplasty.

TypeinterventionalSponsorWake Forest University Health SciencesRan2016 to 2016Enrolled21ConditionsTourniquets, Knee Arthroplasty, Total, Knee Replacement, TotalArmsTourniquet Cuff Pressure
NCT03931837 naunknown statusnot on this mapstarted 2019, after this paper: background citation

Efficacy Testing of Different Tourniquet Pressure Used for Postoperative Pain Reduction in Total Knee Arthroplasty: A Prospective, Randomized Controlled Trials

TypeinterventionalSponsorThammasat UniversityRan2019 to 2020Enrolled150ConditionsOsteoarthritis, KneeArmsTourniquet: Systolic blood pressure + 75 mmHg, Tourniquet: Systolic blood pressure + 100 mmHg, Tourniquet: Systolic blood pressure + 150 mmHg
NCT06781021 naenrolling by invitationnot on this mapstarted 2024, after this paper: background citation

The Effect of Tranexamic Acid Vs Torniquet on Visual Clarity in Knee Arthroscopic Anterior Cruciate Ligament (ACL) Reconstruction

TypeinterventionalSponsorThe University of The West IndiesRan2024 to 2026Enrolled60ConditionsACL TearsArmsTourniquet, TXA
3 · Its place in the literature

Who cites it

65 citing papers in PubMed, 11 syntheses or guidelines pooled it, 145 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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  6. Tourniquet use for knee replacement surgery.The Cochrane database of systematic reviews · 2020
    Pooled it
  7. 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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  12. [Fast-Track-Arthroplasty].Orthopadie (Heidelberg, Germany) · 2024
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  19. Tourniquet application during TKA did not affect the accuracy of implant positioning: a randomized clinical trial.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2018
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5 more citing papers are in PubMed but not listed here.

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

4 authors at 3 institutions in 1 country.

David LiuGold Coast Centre for Bone and Joint Surgery, John Flynn Private Hospital, Gold Coast, Australia.
David GrahamDepartment of Orthopedic Surgery, Gold Coast and Robina Hospitals, Gold Coast, Australia.
Kim GilliesClinical Data Solutions, Sydney, Australia.
R Mark GilliesUniversity of Sydney, Kolling Institute, Murray Maxwell Biomechanics Laboratory, Royal North Shore Hospital, Sydney, Australia.
Gold Coast Hospital · AURobina Hospital · AUUniversity of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeA pneumatic tourniquet is commonly used in total knee arthroplasty (TKA) to improve surgical field visualisation but may result in quadriceps muscle ischaemia. We performed this study to analyse the effect of the tourniquet on recovery following TKA. MATERIALS AND

methodsA prospective randomised single-blinded trial was undertaken to examine the effect of the tourniquet on post-operative pain, swelling, blood loss, quadriceps function and outcome following TKA. Twenty patients with osteoarthritis of the knee were randomised to tourniquet or no tourniquet groups. Quadriceps function was assessed using surface electromyography (EMG) during active knee extension.

resultsThe no tourniquet group had significantly less pain in the early post-operative period compared to the tourniquet group. There was no difference in Oxford knee score, range of motion, or thigh and knee swelling up to 12 months post-operatively. Quadriceps function, measured by surface EMG, was compromised for the first six months post-surgery by tourniquet use. The radiological cement mantle at the bone prosthesis interface at 12-month follow-up was not affected by the absence of a tourniquet.

conclusionsWe believe that it is safe and beneficial for our patients to routinely perform TKA without a tourniquet.

Indexed as

ArthroplastyKneePainQuadricepsTourniquet

Identifiers

PMID25505702
PMCPMC4258487
OpenAlexW1991963041

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.