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Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2018

Open Access 01-12-2018 | Research article

Comparison of tourniquet application only during cementation and long-duration tourniquet application in total knee arthroplasty: a meta-analysis

Authors: Cong Wang, Chenhe Zhou, Hao Qu, Shigui Yan, Zhijun Pan

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2018

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Abstract

Background

Tourniquet is widely used by orthopedic surgeons in total knee arthroplasty (TKA). However, there are still controversies on the optimal timing of tourniquet application. The aim of this meta-analysis was to compare the effect and safety of tourniquet application only during cementation with long-duration tourniquet application in TKA.

Methods

An electronic literature search of PubMed, the Cochrane library, Embase, and Web of Science was conducted in July 2017. All randomized controlled trials (RCTs) comparing tourniquet application only during cementation with long-duration tourniquet application in TKA were included. RevMan 5.3 software was selected to perform the meta-analysis.

Results

Seven studies involving 440 TKAs were included for meta-analysis. The results suggested that although significant less intraoperative and total blood loss were observed with long-duration tourniquet application, tourniquet application only during cementation would not increase the number of transfusion and operation time. Tourniquet application only during cementation results in less knee pain on post-operative day 1 (POD 1), less time needed to achieve straight-leg raise, and less minor complications following TKA.

Conclusions

Tourniquet application only during cementation might reduce the rate of minor complications and have faster functional recovery during the early rehabilitation period following TKA, but it could not limit intraoperative and total blood loss. No definitive conclusions can be drawn based on the current evidences. Further, large well-designed RCTs with extensive follow-up are still needed to validate this research.
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Metadata
Title
Comparison of tourniquet application only during cementation and long-duration tourniquet application in total knee arthroplasty: a meta-analysis
Authors
Cong Wang
Chenhe Zhou
Hao Qu
Shigui Yan
Zhijun Pan
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2018
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-018-0927-6

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