Effect of tourniquet application on cement penetration in primary total knee arthroplasty: a meta-analysis

Abstract Background Tourniquet application is expected to improve surgery exposure and cementation process in total knee arthroplasty (TKA) but its effectiveness remains controversial and needs to be further explored. The aim of this meta-analysis was to assess the effect of tourniquet in primary TK...

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Main Authors: Shuxin Yao, Weijie Zhang, Jianbing Ma, Jianpeng Wang
Format: Article
Language:English
Published: BMC 2021-08-01
Series:Arthroplasty
Subjects:
Online Access:https://doi.org/10.1186/s42836-021-00083-7
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spelling doaj-2781f2f4f8d542c99e8b31292bdf17c02021-08-08T11:45:27ZengBMCArthroplasty2524-79482021-08-01311910.1186/s42836-021-00083-7Effect of tourniquet application on cement penetration in primary total knee arthroplasty: a meta-analysisShuxin Yao0Weijie Zhang1Jianbing Ma2Jianpeng Wang3Department of Orthopedics Honghui Hospital, Xi’An Jiaotong UniversityDepartment of Orthopedics Honghui Hospital, Xi’An Jiaotong UniversityDepartment of Orthopedics Honghui Hospital, Xi’An Jiaotong UniversityDepartment of Orthopedics Honghui Hospital, Xi’An Jiaotong UniversityAbstract Background Tourniquet application is expected to improve surgery exposure and cementation process in total knee arthroplasty (TKA) but its effectiveness remains controversial and needs to be further explored. The aim of this meta-analysis was to assess the effect of tourniquet in primary TKA. The hypothesis is that the tourniquet application affects the cement penetration in TKA. Methods A search was conducted in PubMed, Embase, and the Cochrane Library for the potentially eligible articles. Two independent researchers reviewed the articles retrieved against the pre-designed inclusion and exclusion criteria. In primary TKA, cement penetration was assessed, and the data between the tourniquet-assisted and non-tourniquet-assisted TKAs were compared. Statistical significance was set at P < 0.05. Results A total of 4 randomized controlled trials and 3 non-randomized controlled trials (involving 675 patients) were included. There was no significant difference between the tourniquet-assisted and non-tourniquet-assisted TKAs in terms of cement penetration (P > 0.05). There were no significant differences in the total surgical time, blood loss, blood transfusion, the Knee Society Score, and the visual analogue scale (VAS) between the two kinds of procedures (P > 0.05). Conclusions Tourniquet application may not affect cement penetration in primary TKA and may not help reduce blood loss, ease knee pain or improve the knee function. A surgeon may choose to use a tourniquet or not according to his or her own preference. Level of Evidence Level Ib, meta-analysis.https://doi.org/10.1186/s42836-021-00083-7Total knee arthroplastyTourniquetCementMeta-analysis
collection DOAJ
language English
format Article
sources DOAJ
author Shuxin Yao
Weijie Zhang
Jianbing Ma
Jianpeng Wang
spellingShingle Shuxin Yao
Weijie Zhang
Jianbing Ma
Jianpeng Wang
Effect of tourniquet application on cement penetration in primary total knee arthroplasty: a meta-analysis
Arthroplasty
Total knee arthroplasty
Tourniquet
Cement
Meta-analysis
author_facet Shuxin Yao
Weijie Zhang
Jianbing Ma
Jianpeng Wang
author_sort Shuxin Yao
title Effect of tourniquet application on cement penetration in primary total knee arthroplasty: a meta-analysis
title_short Effect of tourniquet application on cement penetration in primary total knee arthroplasty: a meta-analysis
title_full Effect of tourniquet application on cement penetration in primary total knee arthroplasty: a meta-analysis
title_fullStr Effect of tourniquet application on cement penetration in primary total knee arthroplasty: a meta-analysis
title_full_unstemmed Effect of tourniquet application on cement penetration in primary total knee arthroplasty: a meta-analysis
title_sort effect of tourniquet application on cement penetration in primary total knee arthroplasty: a meta-analysis
publisher BMC
series Arthroplasty
issn 2524-7948
publishDate 2021-08-01
description Abstract Background Tourniquet application is expected to improve surgery exposure and cementation process in total knee arthroplasty (TKA) but its effectiveness remains controversial and needs to be further explored. The aim of this meta-analysis was to assess the effect of tourniquet in primary TKA. The hypothesis is that the tourniquet application affects the cement penetration in TKA. Methods A search was conducted in PubMed, Embase, and the Cochrane Library for the potentially eligible articles. Two independent researchers reviewed the articles retrieved against the pre-designed inclusion and exclusion criteria. In primary TKA, cement penetration was assessed, and the data between the tourniquet-assisted and non-tourniquet-assisted TKAs were compared. Statistical significance was set at P < 0.05. Results A total of 4 randomized controlled trials and 3 non-randomized controlled trials (involving 675 patients) were included. There was no significant difference between the tourniquet-assisted and non-tourniquet-assisted TKAs in terms of cement penetration (P > 0.05). There were no significant differences in the total surgical time, blood loss, blood transfusion, the Knee Society Score, and the visual analogue scale (VAS) between the two kinds of procedures (P > 0.05). Conclusions Tourniquet application may not affect cement penetration in primary TKA and may not help reduce blood loss, ease knee pain or improve the knee function. A surgeon may choose to use a tourniquet or not according to his or her own preference. Level of Evidence Level Ib, meta-analysis.
topic Total knee arthroplasty
Tourniquet
Cement
Meta-analysis
url https://doi.org/10.1186/s42836-021-00083-7
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