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Tourniquet use does not affect rehabilitation, return to activities, and muscle damage after arthroscopic
Alexander Tsarouhas1, Michael E Hantes, Georgios Tsougias
1Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Thessalia, Larissa, Greece.
Purpose:
The purpose of this prospective randomized trial was to examine the effect of tourniquet use on rehabilitation rate, return to work and sport activities, and muscle damage after arthroscopic meniscectomy.
Methods:
Eighty patients who underwent arthroscopic partial meniscectomy were randomly allocated to the use of an inflated (group A, n = 40) or deflated (group B, n = 40) pneumatic tourniquet. Patients with concomitant ligamentous deficiency or grade III and IV chondral lesions were excluded. The primary outcome measures were pain, measured with a visual analog scale (VAS), and knee range of motion (ROM) on days 8 and 15 postoperatively; time required for patients to discontinue the use of crutches; time to return to light activities and moderate sporting activities such as jogging; and serum creatine phosphokinase (CPK) levels monitored preoperatively and on days 1, 8, and 15 postoperatively.
Results:
The 2 groups did not differ in terms of age; male-female ratio; body mass index; and preoperative International Knee Documentation Committee, Tegner, and Lysholm scores. Operative time was not significantly different between groups (mean, 27.5 for group A and 31.2 for group B; P = .83). VAS pain scores and knee ROM were not significant between groups (minimum P = .22). The patients progressed to weight-bearing without crutches within 13.4 and 12.9 days for groups A and B, respectively (P = .9). Return to work and jogging did not differ significantly between groups (minimum P = .34). Serum CPK values were also not significantly different between or within groups during consecutive measurements (P = .3). Tourniquet time did not significantly affect postoperative ROM, VAS pain scores, or serum CPK levels (minimum P = .14).
Conclusions:
Tourniquet use for less than 30 minutes during arthroscopic meniscectomy does not affect postoperative pain or return to light work and jogging. In addition, tourniquet-induced muscle damage after arthroscopic meniscectomy, though potentially present locally, is not detectable in the systemic circulation.
Level Of Evidence:
Level I, prospective randomized trial.