Evidence map›Paper›PMID 31190247›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2020

Tibial cement mantle thickness is not affected by tourniquetless total knee arthroplasty when performed with tranexamic acid.

Carl L Herndon, Matthew J Grosso, Nana O Sarpong, Roshan P Shah, Jeffrey A Geller, H John Cooper

Abstract read
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In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 2 pooled it
3.5field-weighted citation impact, top 7% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.

  1. Pooled it
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  5. [Fast-Track-Arthroplasty].Orthopadie (Heidelberg, Germany) · 2024
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  14. 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
  15. Review
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

6 authors at 1 institution in 1 country.

Carl L HerndonDepartment of Orthopedic Surgery, Center for Hip and Knee Replacement, Columbia University Irving Medical Center, 622 West 168th Street PH 1138, New York, NY, 10032, USA. ch3181@cumc.columbia.edu.ORCID http://orcid.org/0000-0001-5590-1509
Matthew J GrossoDepartment of Orthopedic Surgery, Center for Hip and Knee Replacement, Columbia University Irving Medical Center, 622 West 168th Street PH 1138, New York, NY, 10032, USA.
Nana O SarpongDepartment of Orthopedic Surgery, Center for Hip and Knee Replacement, Columbia University Irving Medical Center, 622 West 168th Street PH 1138, New York, NY, 10032, USA.
Roshan P ShahDepartment of Orthopedic Surgery, Center for Hip and Knee Replacement, Columbia University Irving Medical Center, 622 West 168th Street PH 1138, New York, NY, 10032, USA.
Jeffrey A GellerDepartment of Orthopedic Surgery, Center for Hip and Knee Replacement, Columbia University Irving Medical Center, 622 West 168th Street PH 1138, New York, NY, 10032, USA.
H John CooperDepartment of Orthopedic Surgery, Center for Hip and Knee Replacement, Columbia University Irving Medical Center, 622 West 168th Street PH 1138, New York, NY, 10032, USA.
Columbia University Irving Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeEvidence exists that tourniquet use leads to increased cement penetration in total knee arthroplasty (TKA) due to decreased blood and fat in the bone during cementation. The use of tranexamic acid (TXA) has led to decreased blood loss and transfusion rates. The purpose of this study was to determine if the use of a tourniquet while utilising modern TXA protocols affects the tibial cement mantle penetration.

methods140 patients who underwent primary TKA with and without a tourniquet (70 in each group) were retrospectively reviewed. All patients received a standard TXA protocol. The primary outcome measure was cumulative depth of cement mantle penetration of the tibial plateau on post-operative radiographs. Secondary outcome measures included post-operative change in haemoglobin and hematocrit levels, blood loss, and transfusion rates.

resultsThere was no significant difference in age, sex, or pre-operative haemoglobin or hematocrit levels between groups. Tourniquet use resulted in significantly lower blood loss (100.0 mL versus 154.7 mL, p < 0.001), and significantly reduced drop in haemoglobin (1.8 g/dL vs 2.5 g/dL, p < 0.001) and hematocrit (5.7% vs 7.4%, p = 0.04) levels. However, depth of tibial cement mantle penetration did not differ between the tourniquet group (15.3 mm) and non-tourniquet group (15.0 mm, p value n.s.). No patient in either group required a blood transfusion.

conclusionsTourniquet use in primary TKA results in decreased blood loss and less change in pre-operative vs post-operative haemoglobin and hematocrit levels. However, with the use of TXA, not using a tourniquet resulted in similar cement mantle penetration around the tibial component as with a tourniquet.

Indexed as

AgedAntifibrinolytic AgentsArthroplasty, Replacement, KneeBlood Loss, SurgicalBone CementsCementationFemaleHumansMaleMiddle AgedRetrospective StudiesTibiaTourniquetsTranexamic AcidAntifibrinolytic AgentsBone CementsTranexamic AcidCementationCement penetrationTotal knee arthroplastyTotal knee replacementTourniquetTranexamic acid

Identifiers

PMID31190247
OpenAlexW2950104597

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.