Evidence map›Paper›PMID 37417882›Full record

Observational studyActa orthopaedica2023

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.

Pelle Baggesgaard Petersen, Mette Mikkelsen, Christoffer Calov Jørgensen, Andreas Kappel, Anders Troelsen, Henrik Kehlet, Kirill Gromov, Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group

Abstract readObservational StudyMulticenter Study
In one paragraph

Observational study in Acta orthopaedica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. 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

8 authors.

Pelle Baggesgaard PetersenSection for Surgical Pathophysiology, Rigshospitalet, Copenhagen; Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty, Rigshospitalet, Copenhagen. pelle.baggesgaard.petersen@regionh.dk.
Mette MikkelsenLundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty, Rigshospitalet, Copenhagen.
Christoffer Calov JørgensenSection for Surgical Pathophysiology, Rigshospitalet, Copenhagen; Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty, Rigshospitalet, Copenhagen.
Andreas KappelDepartment of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark.
Anders TroelsenDepartment of Orthopaedic Surgery, Clinical Orthopaedic Research Hvidovre (CORH), Copenhagen University Hospital Hvidovre, Hvidovre.
Henrik KehletSection for Surgical Pathophysiology, Rigshospitalet, Copenhagen; Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty, Rigshospitalet, Copenhagen.
Kirill GromovLundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty, Rigshospitalet, Copenhagen; Department of Orthopaedic Surgery, Clinical Orthopaedic Research Hvidovre (CORH), Copenhagen University Hospital Hvidovre, Hvidovre.
Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeVenous thromboembolism (VTE) is a serious postoperative complication after total knee arthroplasty (TKA). Use of a tourniquet has shown conflicting results for risk of VTE after TKA. We aimed to investigate the associated risk of VTE after TKA using tourniquet in a fast-track set-up as no previous data exists. PATIENTS AND

methodsWe performed an observational cohort study from 9 fast-track centers including unilateral primary TKA from 2010-2017 with prospective collection of preoperative risk-factors and complete 90-day follow-up. Use of a tourniquet was registered in the Danish Knee Arthroplasty Register. Postoperative VTE was identified from health records. We performed risk analyses using a mixed-effects logistic regression model adjusting for previously identified risk factors.

resultsOf the 16,250 procedures (39% males, mean age 67.9 [SD 10.0] years, median LOS 2 [interquartile range 2-3]) 12,518 (77%) were performed with a tourniquet. The annual tourniquet usage varied greatly between departments from 0% to 100%, but also within departments from 0% to 99%. There was no significant difference between the 2 groups with 52 (0.42%) VTEs in the tourniquet group vs. 25 (0.67%) in the no-tourniquet group (p = 0.06 for cumulative 90-day incidence of VTE). This association remained statistically insignificant for VTE using tourniquet after adjustment for previously identified risk factors.

conclusionWe found no association between the use of a tourniquet and increased risk of 90-day VTE after primary fast-track TKA, irrespective of the length of time for which the tourniquet was applied.

Indexed as

Arthroplasty, Replacement, KneeVenous ThromboembolismAgedCohort StudiesFemaleHumansMalePostoperative ComplicationsProspective StudiesRisk Factors

Identifiers

PMID37417882
PMCPMC10327675

What OpenQuestion holds

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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.