D S Johnson1, H Stewart, P Hirst, N J Harper. 1. Department of Orthopaedics, Manchester Royal Infirmary, Manchester, England. David.Johnson@nwota.demon.co.uk
Abstract
PURPOSE: With several studies identifying the tourniquet as a factor for increased risk of complications in knee arthroscopy, we wished to identify whether its use is necessary. TYPE OF STUDY: We performed a prospective randomized trial on 109 patients undergoing knee arthroscopy. MATERIALS AND METHODS: All patients had a tourniquet placed on the thigh and were assigned to either have it inflated or not inflated. Personal information, operative details, postoperative pain scores, analgesic requirements, and complications were recorded. RESULTS: The 2 groups were comparable. There was no significant difference between the 2 groups with respect to operative view, duration of operation, pain scores, analgesic requirements, or complications. The tourniquet required intraoperative inflation in 4 patients assigned not to have it inflated; in 1 patient, the tourniquet made no difference to the operative view. CONCLUSIONS: Many orthopaedic units continue to use a tourniquet routinely for knee arthroscopy, probably in the belief that a clear operative view can only be achieved with one. However, the findings in our trial indicate that knee arthroscopy may be performed adequately without the use of a tourniquet. Therefore, we recommend that its routine use for this procedure is discontinued.
RCT Entities:
PURPOSE: With several studies identifying the tourniquet as a factor for increased risk of complications in knee arthroscopy, we wished to identify whether its use is necessary. TYPE OF STUDY: We performed a prospective randomized trial on 109 patients undergoing knee arthroscopy. MATERIALS AND METHODS: All patients had a tourniquet placed on the thigh and were assigned to either have it inflated or not inflated. Personal information, operative details, postoperative pain scores, analgesic requirements, and complications were recorded. RESULTS: The 2 groups were comparable. There was no significant difference between the 2 groups with respect to operative view, duration of operation, pain scores, analgesic requirements, or complications. The tourniquet required intraoperative inflation in 4 patients assigned not to have it inflated; in 1 patient, the tourniquet made no difference to the operative view. CONCLUSIONS: Many orthopaedic units continue to use a tourniquet routinely for knee arthroscopy, probably in the belief that a clear operative view can only be achieved with one. However, the findings in our trial indicate that knee arthroscopy may be performed adequately without the use of a tourniquet. Therefore, we recommend that its routine use for this procedure is discontinued.
Authors: Ryan H Barnes; M Leslie Golden; David Borland; Reed Heckert; Meghan Richardson; R Alexander Creighton; Jeffrey T Spang; Ganesh V Kamath Journal: Arthrosc Sports Med Rehabil Date: 2021-12-07
Authors: Krzysztof Hermanowicz; Adrian Góralczyk; Kinga Danowska; Dariusz Gałązka; Robert F LaPrade; Konrad Malinowski Journal: Arthrosc Tech Date: 2019-11-11