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Does Tourniquet Use in TKA Increase Postoperative Pain? A Systematic Review and Meta-analysis
Eoin McCarthy Deering1, Shu Yang Hu, Ali Abdulkarim
1E. McCarthy Deering, S. Y. Hu, Royal College of Surgeons, Dublin, Ireland A. Abdulkarim, Department of Trauma & Orthopaedic Surgery, Cambridge University Hospital, Addenbrooke's Hospital, Cambridge, UK,
Clinical Orthopaedics and Related Research
|November 22, 2018
Summary
This meta-analysis found no significant differences in postoperative pain, range of motion, or hospital stay for total knee arthroplasty (TKA) patients whether or not a tourniquet was used. Long-term outcomes require further study.
Area of Science:
- Orthopedic Surgery
- Evidence-Based Medicine
- Clinical Trials
Background:
- Tourniquet use in total knee arthroplasty (TKA) is controversial.
- Quantifying tourniquet impact on patient-reported outcomes like pain is crucial.
Purpose of the Study:
- To meta-analyze randomized trials on tourniquet use in TKA.
- To determine if tourniquets affect postoperative pain, range of motion (ROM), or hospital length of stay (LOS).
Main Methods:
- Systematic review and meta-analysis following PRISMA guidelines.
- Searched PubMed, Embase, and Cochrane databases up to February 2015.
- Analyzed 8 randomized controlled trials (430 patients) for pain, ROM, and LOS.
Main Results:
- No clinically important difference in postoperative pain (VAS) between tourniquet and no-tourniquet groups.
- No significant difference in postoperative range of motion (ROM) or length of stay (LOS).
- Subgroup analysis also showed no difference in pain with partial tourniquet use.
Conclusions:
- No short-term benefits or harms identified for tourniquet use in TKA regarding pain, ROM, or LOS.
- Long-term effects on survivorship and function warrant further investigation.
- Recommend long-term follow-up of TKA patients to assess potential delayed outcomes.
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