Hiroshi Nakayama1, Shinichi Yoshiya. 1. Department of Orthopaedic Surgery, Hyogo College of Medicine, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan. hiroshi0273@mac.com
Abstract
PURPOSE: The purpose of this study was to examine the effect of tourniquet use on operative performance and early postoperative results of anatomic double-bundle anterior cruciate ligament (ACL) reconstruction. METHODS:Fifty-one patients who underwent scheduled ACL reconstruction for unilateral ACL deficiency from June 2010 to October 2011 were included in this study. The mean age at surgery was 26.3 years (range 14-45 years). An anatomic bundle reconstructive procedure with an autogenous hamstring tendon graft was performed in all cases. These patients were randomly divided into two groups: the tourniquet group (T group) and no tourniquet group (NT group). The reconstructive procedure was performed with the use of a tourniquet for 28 patients in the T group, while a tourniquet was inflated only during the graft harvest for 23 patients in the NT group. The surgical procedure and postoperative management were identical for both groups. Inter-group comparison was conducted for intra- and peri-operative clinical parameters as well as early postoperative results (functional recovery at 3 months). RESULTS: The arthroscopic visual field during the procedure was not compromised even without the use of a tourniquet. There was no significant difference in operative time between the groups (P = 0.10). The amount of blood corrected through the intraarticular drain was significantly larger in the T group (P = 0.02), while total blood loss calculated by the postoperative reduction of the hemoglobin value was not significantly different between the groups (P = 0.74). Although the VAS value for postoperative numbness was significantly higher in the T group (P = 0.0002), the VAS value for pain was not significantly different (P = 0.30). Additionally, recovery of muscle strength at 3 months was not significantly different between the groups. CONCLUSION: This comparative study showed that arthroscopic procedures could be uneventfully performed without the use of a tourniquet. The clinical parameters when not using a tourniquet were not significantly different, but the use of a tourniquet resulted in an increase in postoperative intraarticular bleeding and VAS for numbness. LEVEL OF EVIDENCE: Prospective randomized study, Level II.
RCT Entities:
PURPOSE: The purpose of this study was to examine the effect of tourniquet use on operative performance and early postoperative results of anatomic double-bundle anterior cruciate ligament (ACL) reconstruction. METHODS: Fifty-one patients who underwent scheduled ACL reconstruction for unilateral ACL deficiency from June 2010 to October 2011 were included in this study. The mean age at surgery was 26.3 years (range 14-45 years). An anatomic bundle reconstructive procedure with an autogenous hamstring tendon graft was performed in all cases. These patients were randomly divided into two groups: the tourniquet group (T group) and no tourniquet group (NT group). The reconstructive procedure was performed with the use of a tourniquet for 28 patients in the T group, while a tourniquet was inflated only during the graft harvest for 23 patients in the NT group. The surgical procedure and postoperative management were identical for both groups. Inter-group comparison was conducted for intra- and peri-operative clinical parameters as well as early postoperative results (functional recovery at 3 months). RESULTS: The arthroscopic visual field during the procedure was not compromised even without the use of a tourniquet. There was no significant difference in operative time between the groups (P = 0.10). The amount of blood corrected through the intraarticular drain was significantly larger in the T group (P = 0.02), while total blood loss calculated by the postoperative reduction of the hemoglobin value was not significantly different between the groups (P = 0.74). Although the VAS value for postoperative numbness was significantly higher in the T group (P = 0.0002), the VAS value for pain was not significantly different (P = 0.30). Additionally, recovery of muscle strength at 3 months was not significantly different between the groups. CONCLUSION: This comparative study showed that arthroscopic procedures could be uneventfully performed without the use of a tourniquet. The clinical parameters when not using a tourniquet were not significantly different, but the use of a tourniquet resulted in an increase in postoperative intraarticular bleeding and VAS for numbness. LEVEL OF EVIDENCE: Prospective randomized study, Level II.