The value of tourniquet use for visibility during arthroscopy of the knee: a double-blind, randomized controlled
Roy A G Hoogeslag1, Reinoud W Brouwer, Jos J A M van Raay
1Department of Orthopaedic Surgery, ZGT Hospital, Almelo, The Netherlands. Hoogeslag@yahoo.com
Purpose:
To study the value of tourniquet use during routine arthroscopy of the knee.
Methods:
In this randomized, double-blind controlled trial, 245 patients were included from April 2005 until March 2007 and randomized into an inflated tourniquet group (n = 137) or a deflated tourniquet group (n = 108). The primary outcome was intraoperative visibility. Secondary outcomes were the need to intraoperatively inflate the tourniquet because impaired vision impeded the procedure, the number of times and reason (impaired vision or debris) for flushing the knee, the duration of the procedure (in minutes), and the surgeon's impression of whether the tourniquet was inflated during the procedure.
Results:
Intraoperative visibility was statistically significantly better in the group with the inflated tourniquet. In 11 of the 16 cases in which visibility was rated fair/poor (unsatisfactory), the surgeon felt the need to inflate the tourniquet. In all of the cases the tourniquet had not been previously inflated. In all but 1 case the visibility improved to at least to a rating of good. The frequency of flushing the knee intraoperatively was significantly higher in the deflated tourniquet group. The operative time was not significantly different statistically.
Conclusions:
The results of this study support our hypothesis that routine arthroscopy of the knee with an inflated tourniquet significantly improves visibility, but it does not shorten operative time.
Level Of Evidence:
Level I, therapeutic randomized controlled trial.