ArticleInternational orthopaedics2025
Procedures under tourniquet in sickle cell disease: safety evaluated in two hundred and thirty three sickle-cell disease anaemia adult patients in comparison with outcomes in five hundred and seventy four sickle cell anaemia patients with procedures without tourniquet.
Article in International orthopaedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Tourniquet-less total knee arthroplasty does not negatively affect cement penetration: a double-blinded randomized controlled trial.International orthopaedics · 2025Trial
- Tourniquet use in patients with sickle cell trait (SCT): Mediterranean or African ancestry influences complications, demonstrating a higher prevalence than control patients: matched study of nine hundred and forty SCT versus one thousand, two hundred and sixty three non-SCT patients.International orthopaedics · 2025Article
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Abstract
purposeThere is a lack of data evaluating the impact of tourniquet versus no tourniquet surgery in patients with sickle cell disease (SCD).
methodsThe records of 233 sickle cell patients who underwent orthopaedic surgery with a tourniquet between 1978 and 2018 were retrospectively reviewed. This study group (233 patients) was compared to a control group of 574 SCD patients followed by the same surgical team in the same hospital undergoing the same procedures in the same period between 1978 and 2018 but without a tourniquet. Outcomes assessed skin complications, thrombophlebitis, bone necrosis, muscle necrosis or abnormal muscle function, peripheral nerve impairment, elevated blood pressure, post-operative sickle cell crises, and blood loss under a tourniquet.
resultsThe pneumatic tourniquet was primarily applied proximally in both lower and upper limbs. The median tourniquet duration was 65 minutes, with most procedures lasting between 30 and 90 minutes . Postoperative medical complications occurred in both groups, with no significant difference in hospital stay (6.7 vs. 7.1 days). Painful sickling crises affected 86 patients, with a lower prevalence in transfused patients (p = 0.04). Blood loss was significantly lower in the tourniquet group during knee surgeries (438 ml vs. 731 ml, p = 0.031), resulting in fewer transfusions. Skin complications did not affect wound healing. The 90-day incidence of venous thromboembolism (VTE) was 0.4%, with no significant difference between groups. Muscle biopsies showed no necrosis immediately post-surgery, but some necrosis appeared after 12 weeks in the tourniquet group. New bone osteonecrosis cases and infection rates were similar between groups.
conclusionthis study provides valuable insights into the use of tourniquets in sickle cell disease.
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