Tourniquet Use During Cementation Only During Total Knee Arthroplasty: A Randomized Trial

Tarwala, Rupesh; Dorr, Lawrence D.; Gilbert, Philip M.; Wan, Zhinian; Long, William T.

doi:10.1007/s11999-013-3124-2

Cited by 52 publications

(61 citation statements)

References 22 publications

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“…No differences between the groups regarding the translation or rotation of the components as measured by RSA Tarwala et al [26] Randomized trial. To use a tourniquet only during cementation or up to wound closure…”

Section: Ref Type Of Study Outcomementioning

confidence: 99%

“…Besides, patients with a tourniquet did not have neither a higher risk of thromboembolic complications nor significant difference in the time of surgery compared with patients without a tourniquet [25] . Also, in 2013, Tarwala et al [26] in a randomized trial, examined the outcomes of the use of a tourniquet only during cementation and found that it offered bloodless bone for fixation, and did not influence the surgical time, pain, range of knee motion and total blood loss. Consequently, they recommended this method, claiming that it may restrict the possible risks related to prolonged tourniquet use [26] .…”

Section: Cpm: To Use or Not To Use?mentioning

confidence: 99%

“…Also, in 2013, Tarwala et al [26] in a randomized trial, examined the outcomes of the use of a tourniquet only during cementation and found that it offered bloodless bone for fixation, and did not influence the surgical time, pain, range of knee motion and total blood loss. Consequently, they recommended this method, claiming that it may restrict the possible risks related to prolonged tourniquet use [26] . Finally, the prospective randomized study by Molt et al [27] in 2013, underlined that tourniquet use did not affect the stability of the tibial tray of cemented TKA in a 2-year follow-up, as was demonstrated by a radiostereometric analysis.…”

Section: Cpm: To Use or Not To Use?mentioning

confidence: 99%

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Common controversies in total knee replacement surgery: Current evidence

Nikolaou¹

2014

WJO

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Total knee replacement (TKR) is a widely used operation that has radically improved the quality of life of millions of people during the last few decades. However, some technical details, concerning the surgical procedure and the rehabilitation following total knee arthroplasty, are still a matter of a strong debate. In this review of the literature, we have included the best evidence available of the last decade, in an effort to shed light on some of the most controversial subjects related to TKR surgery. Posterior-stabilized or cruciate-retaining prosthesis? To use a tourniquet during operation or not? Do patients need continuous passive motion for their post-surgery rehabilitation? To resurface patella or not? These are some of the most controversial topics that until now have been persistent dilemmas for the orthopedic surgeon. Results of this systematic review of the literature are highly controversial. These conflicting results are an indication that larger and more well conducted high quality trials are needed in order to gain more secure answers. At the same time, it is becoming apparent that a meticulous operative technique, respecting the soft tissue envelope and knowing the principles of alignment and soft tissue balancing, are some of the parameters that might contribute more to achieving the optimal results for the patients. Key words: Total knee replacement; Controversy; Literature review; Patella resurfacing; Patella eversion; Posterior stabilized; Cruciate retaining; Tourniquet; Continuous passive motion Core tip: A literature review has been conducted in an effort to present the best available evidence of the last decade and to shed light on some of the most controversial subjects related to total knee replacement surgery. Patella resurfacing or not? Posterior cruciate retaining or sacrificing? Continuous passive motion or not? Tourniquet or not? These are some of the most debatable topics that until now have been persistent dilemmas for the orthopedic surgeon. Results of this systematic review of the literature are highly controversial. These conflicting results are an indication that larger and better conducted high quality trials are needed in order to gain more secure answers.Nikolaou VS, Chytas D, Babis GC. Common controversies in total knee replacement surgery: Current evidence. World J Orthop 2014; 5(4

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Section: Ref Type Of Study Outcomementioning

confidence: 99%

Section: Cpm: To Use or Not To Use?mentioning

confidence: 99%

Section: Cpm: To Use or Not To Use?mentioning

confidence: 99%

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Common controversies in total knee replacement surgery: Current evidence

Nikolaou¹

2014

WJO

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“…Ejaz et al [19] also reported the same finding. However, Liu et al [14] and Tarwala et al [20] found that although patients who were treated with tourniquet had better muscular function and shorter hospital stay, their twelve-month ROM was not significantly different from that of patients who underwent tourniquet-assisted surgery. On the other hand, electromyographic alterations in the quadriceps muscle were also reported after using tourniquet for knee surgeries [10].…”

Section: Introductionmentioning

confidence: 96%

Comparing the Effects of Two Tourniquet Times on Pain and Knee Range of Motion after Internal Plate Fixation of Tibia Fractures

Khodabakhshi¹,

Mahmoudirad²,

Bahador³

2017

Arch Med

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“…To the editor, We read the Level I study by Tarwala and colleagues [11] with great interest. The study compared the operative tourniquet group to cementation tourniquet group in patients undergoing TKA.…”

mentioning

confidence: 99%