SynthesisJournal of orthopaedic surgery and research2022
Impact of tourniquet during total knee arthroplasty when tranexamic acid was used: a meta-analysis of randomized controlled trials.
Synthesis in Journal of orthopaedic surgery and research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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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.
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Who cites it
13 citing papers in PubMed, 19 citations in OpenAlex.
- Tourniquet Effect on Patients Undergoing Total Knee Arthroplasty: A Single-Blind, Randomized Controlled Trial.Orthopaedic surgery · 2024Trial
- The use of tourniquet in total knee arthroplasty does not impact the functional outcome: a randomised controlled study.Journal of orthopaedic surgery and research · 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
- Impact of intravenous tranexamic acid administration on reduction mammoplasty outcomes.JPRAS open · 2026Article
- BACTERIAL COLONIZATION IN ORTHOPEDIC SURGICAL TOURNIQUETS: A MULTICENTER STUDY.Acta ortopedica brasileira · 2026Article
- TOURNIQUET USE DOES NOT AFFECT BLEEDING AND SURGICAL TIME IN ROBOTIC-ASSISTED KNEE ARTHROPLASTY.Acta ortopedica brasileira · 2026Article
- When to use a tourniquet in primary total knee arthroplasty? A systematic review and meta-analysis.Frontiers in surgery · 2026Review
- Correlation Between Postoperative Pain Intensity and Perioperative Blood Loss After Total Knee Arthroplasty.Advances in orthopedics · 2025Article
- An Analysis of the Use of Anesthetic Blocks versus Local Anesthesia Infiltration in Primary Total Knee Arthroplasty Surgery.Journal of clinical medicine · 2024Article
- Can We Forgo the Use of Tourniquets in Total Knee Arthroplasty?Revista brasileira de ortopedia · 2024Article
- Article
- Tourniquet use in total knee arthroplasty and the risk of infection: a meta-analysis of randomised controlled trials.Journal of experimental orthopaedics · 2022Article
- Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe efficacy of tourniquet use during primary total knee arthroplasty (TKA) is thought to reduce intraoperative blood loss, improve surgical exposure, and optimize cement fixation. Tranexamic acid (TXA) use can decrease postsurgical blood loss and transfusion requirements. This review aimed to appraise the effects of tourniquet use in TKA for patients with tranexamic acid use.
methodsA meta-analysis was conducted to identify relevant randomized controlled trials involving TXA plus a tourniquet (TXA-T group) and use of TXA plus no tourniquet (TXA-NT group) in TKA. Web of Science, PubMed, Embase, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CNKI, and Wanfang database were searched from 2010 through October 2021.
resultsWe identified 1720 TKAs (1690 patients) assessed in 14 randomized controlled trials. Compared with the TXA-NT group, the TXA-T group resulted in less intra-operative blood loss (P < 0.00001) and decreased duration of surgery (P < 0.00001), however more hidden blood loss (P = 0.0004) and less knee range of motion (P < 0.00001). No significant differences were found between two groups in terms of decrease in hemoglobin (P = 0.84), total blood loss (P = 0.79), transfusion rate (P = 0.18), drainage volume (P = 0.06), Visual Analogue Scale (VAS) at either the day of surgery (P = 0.2), 1 day (P = 0.25), 2 day (P = 0.39), 3 day (P = 0.21), 5 day (P = 0.21), 7 day (P = 0.06) or 1 month after surgery (P = 0.16), Hospital for Special Surgery (HSS) score at either 7 day (P = 0.10), 1 month (P = 0.08), 3 month (P = 0.22) or 6 month after the surgery (P = 0.92), Knee circumference (P = 0.28), length of hospital (P = 0.12), and complications such as intramuscular venous thrombosis (P = 0.81), deep venous thrombosis (P = 0.10), superficial infection (P = 0.45), deep wound infection (P = 0.64), and delayed wound healing (P = 0.65).
conclusionNo big differences could be found by using or not tourniquet when use the TXA, though some benefits are related to operation time and less intra-operative blood loss by using tourniquet and TXA, Using the tourniquet was related to more hidden blood loss and less knee range of motion. More adequately powered and better-designed randomized controlled trials (RCTs) studies with long-term follow-up are required to validate this study.
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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.