Evidence map›Paper›PMID 35552912›Full record

ReviewJournal of experimental orthopaedics2022

The mid-term and long-term effects of tourniquet use in total knee arthroplasty: systematic review.

Wardah Rafaqat, Sudhesh Kumar, Tashfeen Ahmad, Zul Qarnain, Khalid Saeed Khan, Riaz Hussain Lakdawala

Open access · goldAbstract readReview
In one paragraph

Review in Journal of experimental orthopaedics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.7field-weighted citation impact, top 16% 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

5 citing papers in PubMed, 8 citations in OpenAlex.

  1. Trial
  2. Review
  3. Article
  4. Article
  5. 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

6 authors at 2 institutions in 2 countries.

Wardah RafaqatAga Khan University, Stadium Road, Karachi, Sindh, 74800, Pakistan.
Sudhesh KumarAga Khan University, Stadium Road, Karachi, Sindh, 74800, Pakistan.ORCID http://orcid.org/0000-0002-2046-4270
Tashfeen AhmadDepartment of Surgery, Aga Khan University, Stadium Road, Karachi, Sindh, 74800, Pakistan. tashfeen.ahmad@aku.edu.
Zul QarnainAga Khan University, Stadium Road, Karachi, Sindh, 74800, Pakistan.
Khalid Saeed KhanBeatriz Galindo Programme, Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.
Riaz Hussain LakdawalaDepartment of Surgery, Aga Khan University, Stadium Road, Karachi, Sindh, 74800, Pakistan.
Aga Khan University · PKUniversidad de Granada · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeA tourniquet is routinely used during total knee arthroplasty (TKA) to reduce intra-operative hemorrhage, though surgery without a tourniquet is becoming popular. To address concerns about the effect of blood at cement interfaces on long-term implant stability, we conducted a systematic review among patients undergoing total knee arthroplasty to determine if TKA with a tourniquet, compared to TKA without a tourniquet or with reduced tourniquet duration, is associated with better mid-term and long-term implant stability.

methodsA literature search was conducted without language restriction in PubMed, Cochrane database and Web of Science from conception to 17th March, 2021. Prospective cohorts, randomized and observational, that compared tourniquet use with a control group, followed patients for 3 months or more and reported outcomes concerning implant stability, limb function, pain and inflammation. Article selection, quality assessment according to the Revised Cochrane risk assessment scale and Newcastle Ottawa Scale, and data extraction were conducted in duplicate. PROSPERO: CRD42020179020.

resultsThe search yielded 4868 articles, from which 16 randomized controlled trials (RCT) and four prospective cohort studies, evaluating outcomes of 1884 knees, were included. Eleven RCTs were evaluated to be low overall risk of bias, five RCTs had some concerns and four cohort studies were good quality. Few studies showed benefits of tourniquet use in mid-term implant stability (1/6), pain (1/11) and limb inflammation (1/5), and long-term implant stability (1/1). One study reported a significantly improved range of motion (1/14) while another reported significantly reduced quadriceps strength (1/6) in the tourniquet group. The remaining studies reported non-significant effect of tourniquet use.

conclusionAlthough few studies indicated benefits of tourniquet use in mid-term pain, limb inflammation, implant loosening and function, and long-term implant loosening, the majority of studies report no significant advantage of tourniquet use in total knee arthroplasty.

Indexed as

Long-term outcomeTKATotal knee arthroplastyTotal knee replacementTourniquet

Identifiers

PMID35552912
PMCPMC9098769
OpenAlexW4280492497

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.