Trial reportBMC musculoskeletal disorders2019
Is lower tourniquet pressure during total knee arthroplasty effective? A prospective randomized controlled trial.
Trial report in BMC musculoskeletal disorders, 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 16 papers, 2 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.
The Efficacy of Using Lower Tourniquet Pressure During Total Knee Arthroplasty: Comparison With Conventional Tourniquet Pressure Group
Effect of Cuff Pressure Level and Protective Padding Material Selection on the Prevention of Skin Complications in Pneumatic Tourniquet Applications in Upper Extremity Surgery: Clinical Research
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Impact of tourniquet during knee arthroplasty: a bayesian network meta-analysis of peri-operative outcomes.Archives of orthopaedic and trauma surgery · 2021Pooled it
- Comparison of efficacy and safety between oral and intravenous administration of tranexamic acid for primary total knee/hip replacement: a meta-analysis of randomized controlled trial.Journal of orthopaedic surgery and research · 2020Pooled it
- Effect of regional nerve block on tourniquet-related injury in pediatric patients undergoing lower limb surgery: a randomized controlled study.Annals of medicine · 2025Trial
- Optimizing surgical field visualization in total knee arthroplasty: a randomized controlled trial comparing esmarch bandages and simple leg elevation.Journal of orthopaedic surgery and research · 2025Trial
- Personalized tourniquet pressure versus uniform tourniquet pressure in trauma orthopedic surgery of extremities: a prospective randomized controlled study.Journal of orthopaedic surgery and research · 2024Trial
- Effect of tourniquet technique on postoperative delirium in elderly patients with total knee arthroplasty: a randomized single-blind controlled trial.BMC anesthesiology · 2022Trial
- An alternative method for personalized tourniquet pressure in total knee arthroplasty: a prospective randomized and controlled study.Scientific reports · 2022Trial
- 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
- Elastic pneumatic tourniquet cuff can reduce postoperative thigh pain after total knee arthroplasty: a prospective randomized trial.BMC musculoskeletal disorders · 2020Trial
- Protective Effects of Rocuronium Bromide on Ischemia-Reperfusion Injury in Skeletal Muscle Induced by Tourniquet in Patients Undergoing Elective Unilateral Total Knee Arthroplasty: A Prospective, Double Blind, Randomized, Controlled Study.Drug design, development and therapy · 2020Trial
- Review
- Optimizing Tourniquet Pressure in Primary Total Knee Arthroplasty: Limb Occlusion Pressure vs Systolic Blood Pressure Method: A Randomised Controlled Study.Indian journal of orthopaedics · 2024Article
- Comparison of Blood Loss between Open-Box Prosthesis and Closed-Box Prosthesis after Primary Total Knee Arthroplasty.Orthopaedic surgery · 2021Article
- Changes in perioperative hemoglobin and hematocrit in patients undergoing total knee arthroplasty: a prospective observational study of optimal timing of measurement.The Journal of international medical research · 2020Observational
- Tourniquet use in routine primary total knee arthroplasty is associated with a higher transfusion rate and longer postoperative length of stay: a real-world study.BMC musculoskeletal disorders · 2020Article
- Development and validation of a nomogram to predict perioperative blood transfusion in patients undergoing total knee arthroplasty.BMC musculoskeletal disorders · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigher tourniquet pressures may be associated with an increased risk of complications. We aimed to determine (1) whether a lower tourniquet pressure [systolic blood pressure (SBP) + 120 mmHg] is as effective as conventional tourniquet pressure (SBP + 150 mmHg) in providing a bloodless surgical field and decreasing blood loss, and (2) whether lowering the tourniquet pressure decreases tourniquet-related complications compared to conventional inflation pressure.
methodsOne hundred and sixty knees in 124 patients undergoing total knee arthroplasty (TKA) were randomly allocated to either conventional (n = 80) or lower inflation pressure group (n = 80). The quality of the initial surgical field and occurrence of intraoperative blood oozing, hemoglobin drop, drained volume and calculated blood loss were assessed as efficacy variables. Safety outcome variables included post-operative pain, tourniquet site skin problems (ecchymosis, bullae, skin necrosis), and other tourniquet-related complications such as nerve palsy, venous thromboembolism, and delayed rehabilitation.
resultsA comparable bloodless surgical field was successfully provided in both groups (100% vs. 99%, p = 1.000). One case in the conventional pressure group and two cases in the lower pressure group showed intraoperative blood oozing (p = 1.000), which was successfully controlled after an increase of 30 mmHg in the tourniquet inflation pressure. There was no difference in the hemoglobin drop, drained volume, and calculated blood loss. The two groups did not differ in any safety outcomes such as post-operative pain, thigh complications, and other tourniquet related complications.
conclusionThis study demonstrates that a tourniquet inflation pressure of 120 mmHg above the SBP is effective method during TKA.
trial registrationThe trial was with ClinicalTrials.gov ( NCT01993758 ) on November 25, 2013.
Indexed as
Identifiers
What OpenQuestion holds
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.