Observational studyActa orthopaedica2026
The risk of revision using tourniquet or not in primary total knee replacement: an observational study from the Swedish Knee Arthroplasty Register.
Observational study in Acta orthopaedica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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.
Who cites it
1 citing paper in PubMed.
- Editorial: The value of arthroplasty registries: from surveillance to societal impact.Acta orthopaedica · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeThe use of a tourniquet in knee replacement surgery is debated. Given the conflicting evidence, we aimed to compare the risk of revision after total knee replacements (TKR) with or without the use of tourniquet.
methodsIn this register based observational study, we included the 5 most common cemented primary TKR models due to osteoarthritis reported to the Swedish Arthroplasty Register 2010-2024 and followed them until December 31, 2024. The first revision for implant loosening was the primary outcome. We estimated the cumulative revision rate (CRR) with 95% confidence interval (CI) using the 1-Kaplan-Meier method. We examined the use of a tourniquet regarding the risk of revision using multiple Cox regression analysis to calculate the hazard ratio (HR) with CI and adjusted for potential confounding factors.
resultsOf the 149,616 TKRs included, 65,570 (44%) were with tourniquet and 84,046 (56%) without tourniquet. The CRR was similar at all time-points for all causes and infection; however, CRR started to increase at 6-7 years for implant loosening with use of a tourniquet. In the Cox regression analysis, the use of a. tourniquet was associated with an increased risk of revision for implant loosening after 5 years (HR 1.56, CI 1.06-2.30). There was no difference in revision for all causes (HR 1.07, CI 0.99-1.15) or infection (HR 1.08, CI 0.97-1.21).
conclusionThe use of a tourniquet was associated with an increased risk of revision for implant loosening after 5 years, while no association was found for all-cause revision or infection. Our results do not support the use of a tourniquet in TKR as a strategy to reduce the risk of revision, either due to all causes, implant loosening, or infection.
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Registered trials
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