Silicone ring tourniquet versus pneumatic cuff tourniquet in total knee arthroplasty surgery: A randomised comparative study

León‐Muñoz, Vicente J.; Lisón-Almagro, Alonso J.; Hernández-Garcı́a, César; López-López, Mirian

doi:10.1016/j.jor.2018.05.025

Cited by 7 publications

(7 citation statements)

References 19 publications

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“…The result showing that a tourniquet effectively reduced intraoperative blood loss was consistent with the result of previous meta-analyses [28, 29] (intraoperative blood loss: − 161.13 [− 203.52, − 118.74], 295 to 631 mL, 88.06–450.39, 279.82 to 116.60). Controlling intraoperative blood loss during TKA has at least two benefits: (1) it can provide a bloodless field of view and (2) it might be beneficial for bone cement to be able to penetrate bone trabeculae, which may contribute to increased stability of the prosthesis [30]. These benefits are the main reasons that surgeons choose to use tourniquets.…”

Section: Discussionmentioning

confidence: 99%

The effects of tourniquet use on blood loss in primary total knee arthroplasty for patients with osteoarthritis: a meta-analysis

et al. 2019

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BackgroundThe tourniquet is a common medical instrument used in total knee arthroplasty (TKA). However, there has always been a debate about the use of a tourniquet and there is no published meta-analysis to study the effects of a tourniquet on blood loss in primary TKA for patients with osteoarthritis.MethodsWe performed a literature review on high-quality clinical studies to determine the effects of using a tourniquet or not on blood loss in cemented TKA. PubMed, Web of Science, MEDLINE, Embase, and the Cochrane Library were searched up to November 2018 for relevant randomized controlled trials (RCTs). We conducted a meta-analysis following the guidelines of the Cochrane Reviewer’s Handbook. We used the Cochrane Collaboration’s tool for assessing the risk of bias of each trial. The statistical analysis was performed with Review Manager statistical software (version 5.3).ResultsEleven RCTs involving 541 patients (541 knees) were included in this meta-analysis. There were 271 patients (271 knees) in the tourniquet group and 270 patients (270 knees) in the no tourniquet group. The results showed that using a tourniquet significantly decreased intraoperative blood loss (P < 0.002), calculated blood loss (P < 0.002), and the time of operation (P < 0.002), but tourniquet use did not significantly decrease postoperative blood loss (P > 0.05), total blood loss (P > 0.05), the rate of transfusion (P > 0.05), and of deep vein thrombosis (DVT) (P > 0.05) in TKA.ConclusionsUsing a tourniquet can significantly decrease intraoperative blood loss, calculated blood loss, and operation time but does not significantly decrease the rate of transfusion or the rate of DVT in TKA. More research is needed to determine if there are fewer complications in TKA without the use of tourniquets.

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Section: Discussionmentioning

confidence: 99%

The effects of tourniquet use on blood loss in primary total knee arthroplasty for patients with osteoarthritis: a meta-analysis

et al. 2019

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“…Their conclusion was that the average operative field space increase using a sterile single use tourniquet compared to a multi-use pneumatic device was 8.98 cm. Le on-Muñoz et al 22 in their study found no statistical significant difference in postoperative serum lactate levels between the patients operated with standard pneumatic tourniquet and the patients operated with silicone ring tourniquet. Jenny JY et al 23 in their study showed no significant difference in the post operative blood loss and hemoglobin drop between the two groups (one with pneumatic tourniquet and other with disposable silicone tourniquet).…”

Section: Discussionmentioning

confidence: 79%

Comparison of local pain and tissue reaction between conventional pneumatic tourniquet and disposable silicone ring tourniquet during Total Knee Arthroplasty

Londhe¹,

Shah²,

Londhe³

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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Background: To study the comparison of conventional pneumatic and disposable silicone ring tourniquet in Total Knee Arthroplasty. Material and methods: This is a prospective randomized control trial. We used conventional pneumatic tourniquet on one side of leg and disposable silicone ring tourniquet on the other side in consecutive 50 simultaneous bilateral TKR patients. Patients having peripheral vascular disease of the lower limb were excluded from the study. The patient demographics & characteristics are identical being the same patient with two different legs. We started the study with null hypothesis. An independent observer assessed the local tourniquet site pain (VAS score 1e10) and local tourniquet site skin reaction at 24 h and 48 h after the TKA. P value < 0.05 was considered significant. Results: There were no local skin complication with disposable tourniquet (0%). 8 out of 50 patients in whom the conventional tourniquet was applied showed local bruising, and two patients had blister formation making the local skin site complication rate 20% (statistically significant, p value0.0196, chisquared test). The VAS score at 24 h was 4.3 ± 1.5 for disposable tourniquet group as against 5.6 ± 2.1 for conventional tourniquet group (statistically significant, p value ¼ 0.0152, t statistic test for comparison of means). The VAS score at 48 h was 2.1 ± 1.5 and 3.3 ± 1.2 for disposable tourniquet group and conventional tourniquet group respectively (statistically significant p value ¼ 0.003, student's t-test). Conclusion: Use of disposable tourniquet has better outcome than the conventional tourniquet with minimal or no local complications. The advantages of the disposable tourniquet are: 1 less local pain, 2. no local skin problems, 3. accurate tourniquet pressure at the application site, 4.0% local contamination. Hence, we recommend use of the disposable tourniquet during the Total Knee Arthroplasty.

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“…Thigh pain has been considered a minor complication after tourniquet use. However, thigh pain following TKA surgery has been one of the most common early postoperative complaints, and can contribute to patient dissatisfaction after TKA [ 1 , 3 , 15 , 16 ]. In a prospective randomized controlled study which compared tourniquet use versus non-tourniquet use in TKA, results showed reduced thigh pain in the non-tourniquet group on postoperative day 4 [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have reported a silicone ring tourniquet as an alternative to the standard pneumatic tourniquet [ 23 – 25 ]. A recent randomized comparative study compared silicone ring tourniquets to conventional cuff tourniquets in TKA [ 15 ]. However, the above mentioned study only compared the serum lactate level, which was not significantly different to that observed with a pneumatic tourniquet.…”

Section: Discussionmentioning

confidence: 99%

Elastic pneumatic tourniquet cuff can reduce postoperative thigh pain after total knee arthroplasty: a prospective randomized trial

Park

Kim

Lee

2020

BMC Musculoskelet Disord

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Background: Tourniquet use is associated with complications such as thigh pain, skin problems, and deep vein thrombosis (DVT). This prospective study aimed to evaluate the efficacy and safety of the pneumatic tourniquet system using an elastic cuff and limb occlusion pressure (LOP) in total knee arthroplasty (TKA). The hypothesis of this study was that an elastic cuff tourniquet would result in less postoperative thigh pain after TKA. Methods: This prospective randomized controlled trial involved a total of 98 patients who underwent primary TKA. They were randomized into two groups: tourniquet system using an elastic cuff and LOP group (Group E) and tourniquet system using a conventional-cuff and LOP group (Group C). Outcomes including postoperative thigh pain assessed using a visual analog scale (VAS), serum muscle enzymes, recommended tourniquet pressure (RTP), bloodlessness of surgical field, surgical time, incidence of DVT, and the frequency of rescue analgesic use after surgery, were compared between groups. Results: Patients in Group E experienced significantly less thigh pain compared to those in Group C on postoperative day 4 (P = 0.01) and day 7 (P = 0.04). The difference between RTP and systolic blood pressure was significantly lower in Group E (P = 0.045). One case of thigh DVT was found in Group E, while no such cases were found in Group C. One and two cases of poor bloodless surgical fields were observed in Group E and Group C, respectively. There was no significant difference in surgical time, levels of serum muscle enzymes, and the frequency of rescue analgesic use between the two groups. Conclusions: The pneumatic tourniquet system using an elastic cuff and LOP reduced early postoperative thigh pain more effectively than did the tourniquet system using a conventional cuff and LOP. Trial registration: #KCT0003149. Registered August 17, 2018-Retrospectively registered.

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Silicone ring tourniquet versus pneumatic cuff tourniquet in total knee arthroplasty surgery: A randomised comparative study

Abstract: SRT may be not disadvantageous compared to the classic PT from the impact on the glycolytic activity caused by the ischaemia.Level of evidence II.

Cited by 7 publications

References 19 publications

The effects of tourniquet use on blood loss in primary total knee arthroplasty for patients with osteoarthritis: a meta-analysis

The effects of tourniquet use on blood loss in primary total knee arthroplasty for patients with osteoarthritis: a meta-analysis

Comparison of local pain and tissue reaction between conventional pneumatic tourniquet and disposable silicone ring tourniquet during Total Knee Arthroplasty

Elastic pneumatic tourniquet cuff can reduce postoperative thigh pain after total knee arthroplasty: a prospective randomized trial

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