Evidence map›Paper›PMID 39478609›Full record

Trial reportJournal of orthopaedic surgery and research2024

The use of tourniquet in total knee arthroplasty does not impact the functional outcome: a randomised controlled study.

Magnus Johnsen, Steinar Havik, Vigdis Schnell Husby, Siri Bjørgen Winther, Olav A Foss, Otto Schnell Husby, Øystein Bjerkestrand Lian

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of orthopaedic surgery and research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03666598 (The Effects of a Tourniquet on Implant Migration and Muscle Strength and Function in Patients Operated With Total Knee Arthroplasty), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–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.

NCT03666598 naunknown statusnot on this map

The Effects of a Tourniquet on Implant Migration and Muscle Strength and Function in Patients Operated With Total Knee Arthroplasty

TypeinterventionalSponsorNorwegian University of Science and TechnologyRan2019 to 2022Enrolled80ConditionsOsteoarthritis, KneeArmsTourniquet
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  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. Article
  3. Review
  4. Observational
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

7 authors.

Magnus JohnsenOrthopaedic Department, Trondheim University Hospital, Post-box 3250 Torgarden, Trondheim, 7006, Norway. magnus.johnsen@stolav.no.
Steinar HavikOrthopaedic Department, Trondheim University Hospital, Post-box 3250 Torgarden, Trondheim, 7006, Norway.
Vigdis Schnell HusbyOrthopaedic Department, Trondheim University Hospital, Post-box 3250 Torgarden, Trondheim, 7006, Norway.
Siri Bjørgen WintherOrthopaedic Department, Trondheim University Hospital, Post-box 3250 Torgarden, Trondheim, 7006, Norway.
Olav A FossOrthopaedic Department, Trondheim University Hospital, Post-box 3250 Torgarden, Trondheim, 7006, Norway.
Otto Schnell HusbyDepartment of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Post-box 8905, Trondheim, NO-7491, Norway.
Øystein Bjerkestrand LianDepartment of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Post-box 8905, Trondheim, NO-7491, Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study evaluates the clinical evidence for performing total knee arthroplasty (TKA) without a tourniquet, a shift from the near-universal use in 2009 to current trends towards tourniquet-less TKA in Norway and Sweden. This change is set against a backdrop of conflicting evidence regarding the positive and negative effects of tourniquet use. QUESTIONS/PURPOSES: The aims were to determine if the tourniquet has an impact on [1] Forgotten Joint Score-12 (FJS-12) at 8 weeks after surgery; [2] postoperative strength and function; [3] postoperative pain and opioid analgesic use; and [4] operative time, bleeding, and length of stay (LOS).

methodsEighty-one patients were randomised to TKA with or without a tourniquet. The outcome measures, FJS-12, muscle strength, functional test, pain, estimated blood loss, haemoglobin (Hb) loss, knee circumference, opioid consumption, and LOS were assessed preoperatively and at 1 day, 8 weeks, and 1 year after surgery.

resultsNo significant difference in FJS-12 scores was found between the two groups at postoperative 8 weeks. However, the tourniquet group showed statistically significant better knee extension strength at 8 weeks (p = 0.045). There were no differences in other outcomes, except for a greater decrease in haemoglobin levels (p = 0.02) and higher estimated perioperative blood loss (p < 0.001) in the no tourniquet group than the torniquet group.

conclusionsOur study indicates that tourniquet use during TKA causes no significant differences in FJS-12 at 8 weeks, significantly reduces bleeding and postoperative Hb loss, and improves quadriceps strength at 8 weeks.

trial registrationClinicaltrails.gov. Registry Number: NCT03666598. Registered 30 August 2018.

Indexed as

Arthroplasty, Replacement, KneePostoperative PainTourniquetsAgedAged, 80 and overBlood Loss, SurgicalFemaleHumansLength of StayMaleMiddle AgedRecovery of FunctionTreatment OutcomeBlood lossFunctional outcomePainStrengthTotal knee arthroplastyTourniquet

Identifiers

PMID39478609
PMCPMC11523877

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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.