Evidence map›Paper›PMID 26745962›Full record

Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2017

The effects of tourniquet use in total knee arthroplasty: a randomized, controlled trial.

Kai Wang, Songjia Ni, Zhichang Li, Qunjie Zhong, Rujun Li, Hu Li, Yan Ke, Jianhao Lin

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04992533 (Tourniquet vs. no Tourniquet During High Tibial Osteotomy：A Randomized Controlled Trial), which is not on this map. Cited by 56 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
56citing papers in PubMed, 8 pooled it
–field-weighted citation impact
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.

NCT04992533 naunknown statusnot on this mapstarted 2019, after this paper: background citation

Tourniquet vs. no Tourniquet During High Tibial Osteotomy：A Randomized Controlled Trial

TypeinterventionalSponsorQilu Hospital of Shandong UniversityRan2019 to 2021Enrolled50ConditionsKnee OsteoarthritisArmsLong-duration tourniquet, Short-duration tourniquet
3 · Its place in the literature

Who cites it

56 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  5. 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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  17. 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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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

8 authors.

Kai WangArthritis Clinic and Research Center, Peking University People's Hospital, Peking University, Xizhimen South Street No. 11, Beijing, China.
Songjia NiArthritis Clinic and Research Center, Peking University People's Hospital, Peking University, Xizhimen South Street No. 11, Beijing, China.
Zhichang LiArthritis Clinic and Research Center, Peking University People's Hospital, Peking University, Xizhimen South Street No. 11, Beijing, China.
Qunjie ZhongArthritis Clinic and Research Center, Peking University People's Hospital, Peking University, Xizhimen South Street No. 11, Beijing, China.
Rujun LiArthritis Clinic and Research Center, Peking University People's Hospital, Peking University, Xizhimen South Street No. 11, Beijing, China.
Hu LiArthritis Clinic and Research Center, Peking University People's Hospital, Peking University, Xizhimen South Street No. 11, Beijing, China.
Yan KeArthritis Clinic and Research Center, Peking University People's Hospital, Peking University, Xizhimen South Street No. 11, Beijing, China.
Jianhao LinArthritis Clinic and Research Center, Peking University People's Hospital, Peking University, Xizhimen South Street No. 11, Beijing, China. linjianhao@pkuph.edu.cn.

Funding

Peking University People's Hospital Research and Development Funds RDC2013-06
6 · The paper itself

Abstract

purposeTourniquets are still widely used in total knee arthroplasty (TKA), although they may be associated with several adverse effects. An observer-blinded, randomized, controlled trial was performed to evaluate the effects of tourniquet use in TKA.

methodsFifty participants who underwent staged bilateral TKA were recruited for this study. The first-side TKA was randomly allocated to either long-duration tourniquet use or short-duration tourniquet use followed by a 3-month washout period and crossover to the other tourniquet strategy for the opposite-side TKA. Blood loss was monitored perioperatively. The operating time, allogeneic blood transfusion rate, thigh pain, knee pain, limb swelling, clinical outcome as measured by the Likert-type Western Ontario and McMaster University (WOMAC) score, straight leg raising and knee active range of motion (ROM) were also recorded.

resultsThe long-duration tourniquet group exhibited reduced total blood loss [-99.1 ml, 95 % confidence interval (CI) -168.1 to -30.1, P = 0.0411] and intraoperative blood loss (-225.2 ml, 95 % CI -369.5 to -80.9, P = 0.0071) compared with the short-duration tourniquet group. However, there were greater postoperative blood loss (69.6 ml, 95 % CI 21.1 to 118.2, P = 0.0282) and hidden blood loss (52.8 ml, 95 % CI 10.5 to 95.1, P = 0.0332) in the long-duration tourniquet group. The short-duration tourniquet group showed better outcomes for thigh and knee pain, limb swelling, WOMAC score at 6-week follow-up, straight leg raising and knee ROM. Similar allogeneic blood transfusion rates were observed for both groups.

conclusionTotal and intraoperative blood losses were reduced with the long-duration tourniquet use, whereas the short-duration tourniquet use would reduce postoperative and hidden blood losses without increasing the allogeneic blood transfusion rate. In addition, short-duration tourniquet use would result in faster recovery and less pain during the early rehabilitation period following TKA. LEVEL OF EVIDENCE: I.

Indexed as

AgedArthroplasty, Replacement, KneeBlood Loss, SurgicalBlood TransfusionEdemaFemaleHumansMaleOntarioOperative TimeOutcome Assessment, Health CarePostoperative HemorrhagePostoperative PeriodRange of Motion, ArticularTime FactorsTourniquetsBlood lossClinical outcomeTotal knee arthroplastyTourniquet

Identifiers

PMID26745962

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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.