Trial reportInternational orthopaedics2021
Tourniquet use in primary total knee arthroplasty is associated with a hypercoagulable status: a prospective thromboelastography trial.
Trial report in International orthopaedics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Total knee arthroplasty with or without a tourniquet: a meta-analysis of randomized controlled trials.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Pooled it
- Controlled hypotension technology can improve patient recovery in the early postoperative period after total knee arthroplasty: A prospective, randomized controlled clinical study.Joint diseases and related surgery · 2024Trial
- Effect of intravenous low-dose norepinephrine on blood loss in non-tourniquet total knee arthroplasty under general anesthesia: a randomized, double-blind, controlled, single-center trial.Journal of orthopaedic surgery and research · 2023Trial
- [Prevention of venous thromboembolism in orthopaedics and traumatology: Austrian interdisciplinary consensus statement 2026].Wiener klinische Wochenschrift · 2026Article
- Coagulation and Inflammatory Responses After Tourniquet Release in Total Knee Arthroplasty: Association with Hemodynamic Instability.Journal of clinical medicine · 2026Article
- Complications Following Aseptic Knee Revision Based on Tourniquet Use.Arthroplasty today · 2026Article
- Tourniquet Duration and Early Clinical and Biomarker Outcomes in Total Knee Arthroplasty: A Comparative Cohort Study.Journal of clinical medicine · 2026Article
- Periarticular Vasoconstrictor Infiltration in a Tourniquet-Free Total Knee Arthroplasty: A Case Report of Effective Blood Loss Control in High-Thrombotic-Risk Patient.Local and regional anesthesia · 2026Article
- Comparing Tourniquet Use and Non-Use in Robot-Assisted Total Knee Arthroplasties.Medicina (Kaunas, Lithuania) · 2025Article
- Development and validation of a nomogram prediction model for perioperative deep vein thrombosis risk in arthroplasty: a retrospective study.Frontiers in medicine · 2025Article
- Management of Venous Thromboembolism After Hip and Knee Arthroplasty.Journal of orthopaedics and sports medicine · 2025Article
- The effect of triple-dose-intravenous tranexamic acid on blood loss in patients undergoing total hip arthroplasty without affecting blood coagulopathy: A prospective thromboelastographic analysis.Acta orthopaedica et traumatologica turcica · 2023Article
- Use of a tourniquet is not associated with increased risk of venous thromboembolism after fast-track total knee arthroplasty: a prospective multicenter cohort study of 16,250 procedures.Acta orthopaedica · 2023Observational
- Robotic-assisted total knee arthroplasty is not associated with increased risk of postoperative deep vein thrombosis.Journal of experimental orthopaedics · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designProspective study. PURPOSE: The main purpose of this study was to investigate whether the use of a tourniquet changes the blood coagulation state following primary total knee arthroplasty (TKA) by means of conventional coagulation tests and thromboelastography (TEG) analyses.
methodsA total of 154 patients who underwent primary unilateral TKA from January 2018 to October 2020 were enrolled. Seventy-nine patients were randomized into a tourniquet group, and 75 were randomized into a no-tourniquet group. Demographic data, surgical time, intra-operative blood loss, transfusion rate, and wound complications were collected. Complete blood count, conventional coagulation tests, and TEG were performed the day before surgery, one day after surgery, three days after surgery, and seven days after surgery. Lower extremity Doppler ultrasound was performed the day before surgery and seven days after surgery.
resultsThe baseline characteristics of the patients were similar between the two groups. Hidden blood loss, transfusion rate, and wound complications were similar between the two groups, but the intra-operative blood loss of the tourniquet group was lower than that of the no-tourniquet group. The calculated total blood loss of the tourniquet group was higher than that of the no-tourniquet group. In terms of conventional coagulation tests and TEG, the tourniquet group had higher values of fibrin degradation products, D-dimer, maximum amplitude, and coagulation index (p < 0.001). The incidence of deep vein thrombosis (DVT) in the tourniquet group was higher than that in the no-tourniquet group (21.5% compared with 8%; p = 0.019).
conclusionThe application of a tourniquet during TKA significantly increases the amount of calculated total blood loss and does not decrease the post-operative transfusion rate. Using a tourniquet in routine TKA exacerbates the early post-operative hypercoagulable status together with a higher incidence of below-knee asymptomatic DVT observed via conventional coagulation tests, TEG, and ultrasonic Doppler.
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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.