Evidence map›Paper›PMID 37119309›Full record

Trial reportJournal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology2023

Tourniquets can further reduce perioperative blood loss in patients on dexamethasone and tranexamic acid during cemented total knee arthritis: a single-center, double-blind, randomized controlled trial.

Wenyu Jiang, Xing Wang, Hong Xu, Menghan Liu, Jinwei Xie, Qiang Huang, Ronghua Zhou, Zongke Zhou, Fuxing Pei

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 38% 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, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Total knee arthroplasty with or without a tourniquet: a meta-analysis of randomized controlled trials.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
    Pooled it
  2. Trial
  3. Trial
  4. Article
  5. 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

9 authors at 2 institutions in 1 country.

Wenyu Jiang *Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China.ORCID http://orcid.org/0000-0001-8461-412X
Xing Wang *Department of Orthopaedics, The Third People's Hospital of Chengdu, Southwest Jiao Tong University, No.37, Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China.ORCID http://orcid.org/0000-0003-0302-924X
Hong Xu *Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China.ORCID http://orcid.org/0000-0002-7905-0873
Menghan Liu *Department of Anesthesiology, West China Hospital, Sichuan University, No.37, Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China.ORCID http://orcid.org/0000-0002-9363-6600
Jinwei XieDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China.ORCID http://orcid.org/0000-0002-0623-6036
Qiang HuangDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China. huangqiang4325@126.com.ORCID http://orcid.org/0000-0001-8617-7621
Ronghua ZhouDepartment of Anesthesiology, West China Hospital, Sichuan University, No.37, Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China.ORCID http://orcid.org/0000-0002-4069-0136
Zongke ZhouDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China.ORCID http://orcid.org/0000-0002-9037-4756
Fuxing PeiDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China.ORCID http://orcid.org/0000-0003-1136-8444
Sichuan University · CNThird People's Hospital of Chengdu · CN

Funding

National Health Commission of the People's Republic of China ZX2021007
6 · The paper itself

Abstract

backgroundMultiple doses of dexamethasone and tranexamic acid can inhibit postoperative inflammation and reduce fibrinolysis and perioperative blood loss in total knee arthroplasty. In this single-center, double-blind, randomized clinical trial, the aim was to investigate whether applying a tourniquet to patients on dexamethasone and tranexamic acid could further reduce perioperative blood loss. MATERIALS AND

methodsPatients who underwent cemented total knee arthroplasty at our hospital were randomized to receive a tourniquet (n = 71) or not (n = 70) during the procedure. All patients received multiple doses of dexamethasone and tranexamic acid perioperatively. The primary outcome was perioperative blood loss, while secondary outcomes were surgery duration, postoperative laboratory indices of inflammation and fibrinolysis, range of knee motion, VAS pain score, knee circumference, knee swelling rate, homologous transfusion, albumin use, and complications.

resultsUsing a tourniquet was associated with significantly lower intraoperative blood loss (P < 0.001) and total blood loss (P = 0.007) as well as significantly shorter surgery duration (P < 0.001). In contrast, the tourniquet did not significantly affect hidden blood loss, postoperative inflammation or fibrinolysis, range of knee motion, VAS pain score, knee circumference, knee swelling rate, homologous transfusion, albumin use, or complications.

conclusionsThe results of this randomized clinical trial demonstrate that applying a tourniquet during cemented total knee arthroplasty to patients receiving multiple doses of dexamethasone and tranexamic acid can further reduce perioperative blood loss without increasing the risk of inflammation, fibrinolysis, or other complications. Thus, it is advised to use tourniquets combined with dexamethasone and tranexamic acid to reduce perioperative blood loss and avoid tourniquet-related adverse events. LEVEL OF EVIDENCE: Therapeutic Level I. Trial registration Chinese Clinical Trail Registry, ChiCTR2200060567. Registered 5 June 2022-retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=171291.

Indexed as

Antifibrinolytic AgentsArthritisTranexamic AcidAlbuminsBlood Loss, SurgicalDexamethasoneHumansInflammationPainTourniquetsAlbuminsAntifibrinolytic AgentsDexamethasoneTranexamic AcidBlood lossDexamethasoneTotal knee arthroplastyTourniquetTranexamic acid

Identifiers

PMID37119309
PMCPMC10148759
OpenAlexW4367368000

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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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.