Evidence map›Paper›PMID 30539303›Full record

Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2019

Tourniquet application does not affect the periprosthetic bone cement penetration in total knee arthroplasty.

Ahmed Jawhar, Vera Stetzelberger, Karl Kollowa, Udo Obertacke

2 registry-linked trialsAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 25 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 4 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.

NCT02475603 naunknown statusnot on this map

Clinical, Biochemical and Neurophysiological Consequences of Intraoperative

TypeinterventionalSponsorUniversitätsmedizin MannheimRan2012 to 2016Enrolled100ConditionsMuscles IschemiaArmsTotal knee arthroplasty
NCT04992533 naunknown statusnot on this map

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

25 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. 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
    Pooled it
  5. Trial
  6. [Fast-Track-Arthroplasty].Orthopadie (Heidelberg, Germany) · 2024
    Trial
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  8. Trial
  9. Trial
  10. Article
  11. Article
  12. Article
  13. Article
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  16. Review
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  18. Comparing the effect of tourniquet and tranexamic acid on the tibial cement mantle thickness in total knee arthroplasty.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2022
    Article
  19. Review
  20. Article
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.

Ahmed JawharDepartment of Orthopaedics and Trauma Surgery, University Medical Center Mannheim of University Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. ahmed.jawhar@umm.de.
Vera StetzelbergerDepartment of Orthopaedics and Trauma Surgery, University Medical Center Mannheim of University Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Karl KollowaDepartment of Orthopaedics and Trauma Surgery, University Medical Center Mannheim of University Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Udo ObertackeDepartment of Orthopaedics and Trauma Surgery, University Medical Center Mannheim of University Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePoor scientific evidence exists on the issue of tourniquet application during total knee arthroplasty (TKA). It has been suggested that tourniquet application might improve interdigitation of the cement into the periprosthetic bones due to relatively dry surgical field. The hypothesis of the present study was that tourniquet use did not affect the periprosthetic bone cement penetration.

methodsThe single-centre, randomized, controlled trial included 86 patients undergoing primary TKA (Clinical-Trials.gov NCT02475603). All patients meeting the inclusion criteria were randomly assigned to the tourniquet (n = 43) or non-tourniquet (n = 43) group after obtaining a written informed consent. The cumulative bone cement penetration was radiologically measured in AP (seven zones) and lateral views (three zones) as defined by Knee Society Scoring System. Further parameters such as perioperative blood loss, soft tissue swelling, pain level/analgesic consumption, operative time, length of hospital stay (LOS) and complication rate were statistically compared between the groups.

resultsThe cumulative bone cement penetration averaged 28.5 ± 1.7 mm in tourniquet versus 26.6 ± 1.6 mm in non-tourniquet groups (n.s.). The mean intraoperative blood loss was 250 ml higher in the non-tourniquet group (p = 0.0001). Patient-reported pre- to 6th-day post-operative reduction of the pain level was significantly higher in the non-tourniquet group (p = 0.003). The Morphine Equivalent Dose was higher in the Tourniquet group at discharge day (p = 0.02). Parameters such as total blood loss, soft tissue swelling, surgical time, LOS, and complication rates revealed similar results between the groups.

conclusionsTourniquet application did not influence the bone cement penetration significantly. Even though the intraoperative blood loss was reduced, the total blood loss was not affected significantly by tourniquet use. There was a tendency of higher post-operative pain and opioid analgesic requirement in the tourniquet group. LEVEL OF EVIDENCE: I.

Indexed as

Bone CementsTourniquetsAgedAged, 80 and overAnalgesics, OpioidArthroplasty, Replacement, KneeBlood Loss, SurgicalFemaleHumansKneeKnee JointLength of StayMaleMiddle AgedMorphineOperative TimeAnalgesics, OpioidBone CementsMorphineBlood lossBone cement penetrationPainSoft tissue swellingSurgical timeTKATourniquet

Identifiers

PMID30539303

What OpenQuestion holds

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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.