Walid Reda1, Ahmed Mahmoud Fouad ElGuindy2, Gomoa Zahry3, Mona Selim Faggal4, Mahmoud Abdel Karim1. 1. Department of Orthopedic Surgery, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt. 2. Department of Orthopedic Surgery, Faculty of Medicine, Fayoum University, Elfayoum, Egypt. amg02@fayoum.edu.eg. 3. Department of Anaesthesia, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt. 4. Department of Physical Therapy for Musculoskeletal Disorders, Faculty of Physical Therapy, Beni Suef University, Beni Suef, Egypt.
Abstract
PURPOSE: This work aimed at studying the effect of tourniquet use on surgical performance and peri-operative outcomes of anatomic single-bundle ACL reconstruction. METHODS:Eighty-four patients undergoing ACL surgery were randomized into two groups: the tourniquet (A) group and the non-tourniquet (B) group. Post-operative pain, need for analgesics, the volume of blood obtained in the drain, girth diameter changes in the thigh and calf, muscle strength and amount of haemarthrosis were used as outcome measures to compare the two groups. RESULTS: Fifty-eight patients were available for analysis. In the A group, the degree of pain and need to analgesics was significantly higher at 4 and 10 h. The volume measured in the surgical drain, at 24 h post-operative, was higher in the A group (p = 0.001). The calf and thigh girth diameters at 2 weeks showed a highly significant girth difference between the two groups (p = 0.001). CONCLUSION: This study showed that tourniquet use in ACL reconstruction increases immediate post-operative symptoms of pain and haemarthrosis and that the effects on muscle strength are only temporary. The tourniquet can be replaced by using of a mixture of morphine and adrenaline with no interference with the quality of visibility, nor operative time. LEVEL OF EVIDENCE: I.
RCT Entities:
PURPOSE: This work aimed at studying the effect of tourniquet use on surgical performance and peri-operative outcomes of anatomic single-bundle ACL reconstruction. METHODS: Eighty-four patients undergoing ACL surgery were randomized into two groups: the tourniquet (A) group and the non-tourniquet (B) group. Post-operative pain, need for analgesics, the volume of blood obtained in the drain, girth diameter changes in the thigh and calf, muscle strength and amount of haemarthrosis were used as outcome measures to compare the two groups. RESULTS: Fifty-eight patients were available for analysis. In the A group, the degree of pain and need to analgesics was significantly higher at 4 and 10 h. The volume measured in the surgical drain, at 24 h post-operative, was higher in the A group (p = 0.001). The calf and thigh girth diameters at 2 weeks showed a highly significant girth difference between the two groups (p = 0.001). CONCLUSION: This study showed that tourniquet use in ACL reconstruction increases immediate post-operative symptoms of pain and haemarthrosis and that the effects on muscle strength are only temporary. The tourniquet can be replaced by using of a mixture of morphine and adrenaline with no interference with the quality of visibility, nor operative time. LEVEL OF EVIDENCE: I.
Authors: Muhamed M Farhan-Alanie; Fatema Dhaif; Alex Trompeter; Martin Underwood; Joyce Yeung; Nick Parsons; Andy Metcalfe; Peter D H Wall Journal: Eur J Orthop Surg Traumatol Date: 2021-04-01
Authors: Avinesh Agarwalla; Anirudh K Gowd; Joseph N Liu; Grant H Garcia; Daniel D Bohl; Nikhil N Verma; Brian Forsythe Journal: Orthop J Sports Med Date: 2019-02-19