Evidence map›Paper›PMID 38568385›Full record

Trial reportArchives of orthopaedic and trauma surgery2024

A staged use of tourniquet does not influence the fast-track recovery after total knee arthroplasty: a prospective randomized study.

Paolo Salari, Giovanni Balato, Giuseppe Cavallo, Vanni Strigelli, Andrea Meccariello, Andrea Baldini

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Archives of orthopaedic and trauma surgery, 2024. 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
1.1field-weighted citation impact, top 28% 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

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Trial
  2. 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

6 authors at 3 institutions in 1 country.

Paolo SalariIstituto Fiorentino di Cura e Assistenza (IFCA), via del Pergolino 4/6, Florence, 50139, Italy. paul.s.89@hotmail.it.
Giovanni BalatoDepartment of Public Health, School of Medicine, Federico II University, Via S. Pansini, Naples, 80131, Italy.
Giuseppe CavalloIstituto Fiorentino di Cura e Assistenza (IFCA), via del Pergolino 4/6, Florence, 50139, Italy.
Vanni StrigelliValdisieve Hospital Florence, via Forlivese 122, San Francesco (Florence), 50060, Italy.
Andrea MeccarielloOspedale dei Pellegrini, Asl Napoli 1 Centro, Naples, 80122, Italy.
Andrea BaldiniIstituto Fiorentino di Cura e Assistenza (IFCA), via del Pergolino 4/6, Florence, 50139, Italy.
Federico II University Hospital · ITOspedale dei Pellegrini · ITUniversity of Florence · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionUpper-tight tourniquet is widely used in Total Knee Arthroplasty in different modalities. However, it has been associated with a negative impact on post-operative muscle strength end pain. This study aimed to investigate the effect of tourniquet on post-operative pain and recovery in enhanced recovery joint surgery. MATERIALS AND

methodsIn this prospective randomized study, we included 116 patients undergoing to TKA. Surgery was performed with a staged use of tourniquet in Group A (58 patients) and without tourniquet in Group B. In the former group a low-pressure tourniquet was deflated after bone cuts to allow hemostasis of posterior recess and re-inflated for cementation. For all patients a multimodal fast-track recovery protocol was used. Time to reach rehabilitation milestones was recorded as primary endpoint. Range of motion, pain, hemarthrosis, total blood loss, surgical field visualization, Knee Score (KS) and Oxford Knee Score (OKS) were considered as secondary outcomes.

results. No statistically significant differences were found (group B: average 1.3 ± 0.6 day; group A: average 1.2 ± 0.5 day). Group A had a shorter mean surgical time and a clearer surgical field visualization. Group B had a larger estimated blood loss and hemoglobin drop without a statistically significant difference in the transfusion rate. No differences between the groups were seen in the KS, OKS and range of motion (ROM) and post-operative joint swelling. Pain score was similar between cohorts and recorded thigh pain was surprisingly greater in group B. DISCUSSION: The use of tourniquet in TKA surgery helps to minimize intraoperative blood loss and improves surgical field visualization. Its application with a modern and staged protocol does not affect the functional outcomes (OKS, KSS, ROM) of the early post operative period without compromising the fast-track recovery.

Indexed as

Arthroplasty, Replacement, KneeTourniquetsAgedBlood Loss, SurgicalEnhanced Recovery After SurgeryFemaleHumansMaleMiddle AgedPostoperative PainProspective StudiesRange of Motion, ArticularRecovery of FunctionBlood lossFast recoveryFast trackSwellingTKATourniquetTranfusion

Identifiers

PMID38568385
OpenAlexW4393854817

What OpenQuestion holds

Textmetadata
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.