Value of Tourniquet Use in Anterior Ankle Arthroscopy: A Randomized Controlled Trial

Dimnjaković, Damjan; Hrabač, Pero; Bojanić, Ivan

doi:10.1177/1071100717702461

Cited by 15 publications

(10 citation statements)

References 21 publications

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“…Because of increased swelling and skin tension, a persistent ischemia may occur on the skin and subcutaneous tissue, which may have predisposed those patients to higher amount of pain and wound healing complications [24]. However, use of a tourniquet did not affect the functional outcome, as the results of AOFAS score was similar between the groups, this outcome is consistent with the study performed by Dimnjakovic et al [8].…”

Section: Discussionsupporting

confidence: 85%

“…Zaidi et al conducted a prospective nonrandomized study to explore the effects of tourniquet use in ankle arthroscopy, they noted that tourniquet use showed no clinical disadvantages in regard to duration of operation, maximum intraoperative uid pressures or visibility, and announced ankle arthroscopy was possible without the use of a tourniquet [22]. Dimnjakovic et al also found that in ation of a tourniquet did not result in increased duration of operation, maximum intraoperative uid pressures or visibility after anterior ankle arthroscopy [8]. Our outcomes corresponded well to both studies above, in which the results of surgical duration were comparable between two groups.…”

Section: Discussionmentioning

confidence: 99%

“…When performing ankle arthroscopic surgery, Zaidi R et al found that in ation of a tourniquet did not result in increased surgical duration, maximum irrigation uid pressures and postoperative complications [7]. Similarly, Dimnjakovic et al found comparable functional outcomes with or without a tourniquet when performing anterior ankle arthroscopy [8].…”

Section: Introductionmentioning

confidence: 99%

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Effect of Tourniquet Use in Ankle Arthroscopic Surgery on Postoperative Recovery: A Prospective Non- Randomized Controlled Study

Huang

Liu

et al. 2020

Preprint

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The aim of this prospective non- randomized controlled study was to explore the effect of tourniquet use on joint swelling, pain, functional outcome, and tourniquet- related ischemia- reperfusion injury (IRI) during ankle arthroscopic surgery.52 patients who received ankle arthroscopy were allocated to had the procedure done with the tourniquet inflated (the Control group, n= 27) or without the tourniquet inflated (the NT group, n= 25). The main outcome measures were: (1) The amount of swelling of the ankle; (2) Pain as measured by a visual analog scale (VAS); (3) The levels of MDA, IMA,TOS, TAS and OSI at 10 min before incision (T1)，after the completion of surgery (T2), and 30 min after tourniquet deflation (T3); (4) The functional outcome as measured by American Orthopaedic Foot and Ankle Society (AOFAS) ankle hindfoot score; (5) The rate of complication. All patients were reviewed at a mean follow- up of 14.2 months (range, 12- 19 months). The mean circumferences of the ankle in the NT group were significantly lower than those in the Control group on postoperative day 2 and 5 (p<0.05). The mean level of VAS in the Control group was significantly higher on postoperative day 2 (p<0.05). The outcomes of AOFAS ankle hindfoot score were comparable between groups postoperatively (p>0.05). The levels of MDA, IMA, TOS and OSI were all significantly lower in the NT group compared at T2 and T3 (p<0.05), and the level of TAS was significantly lower in the NT group at T3 (p<0.05). The complication rates of two groups were comparable (p>0.05).With the use of tourniquet during ankle arthroscopic surgery, there was increased joint swelling and pain postoperatively, and a trend toward increased levels of MDA, IMA, TOS, TAS and OSI intraoperatively. Thus, we do not recommend using a tourniquet in this type of procedure.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of Tourniquet Use in Ankle Arthroscopic Surgery on Postoperative Recovery: A Prospective Non- Randomized Controlled Study

Huang

Liu

et al. 2020

Preprint

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“…The most recent consecutive 23 procedures were performed without the use of the tourniquet because of good experience developed during years with ankle arthroscopy without the tourniquet. 12 No issues were observed during the procedures. No skin disorders or infections were encountered after the operation.…”

Section: Resultsmentioning

confidence: 99%

Importance of Space-Occupying Anatomical Variations in Peroneal Tendoscopy

2020

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Background: We hypothesized that peroneal tendons disorders are more commonly associated with anatomical variations, which could overcrowd the retrofibular groove. Methods: This single-center retrospective case study covered 84 consecutive cases that had undergone peroneal tendoscopy. Peroneal tendoscopy was performed on 82 patients, predominantly female (3:1) with a median age of 46 years. The preoperative evaluation and all the procedures were performed by a single surgeon using a standardized technique. Results: Two patients required revision surgery 8 and 52 months after the index procedure due to persistent posterolateral ankle pain. Peroneal tendoscopy was performed as a solitary procedure in 45.1% (37/82) of cases, while the remaining cases involved peroneal tendoscopy as a supplementary procedure. Low-lying peroneus brevis muscle belly (LLMB) was the most common finding in this series in 53.7% (44/82) of cases. In 41.5% (34/82) of cases, longitudinal tears of the peroneus brevis tendon were noted. Some patients presented with more than 1 concomitant peroneal tendon pathology. The LLMB was observed in 23.5% (8/34) of cases with a longitudinal tear of the peroneus brevis tendon. Conclusion: Peroneal tendon anatomical variations, especially LLMB, were associated with the presence of peroneus brevis tendon ruptures and intrasheath peroneal tendon subluxations as well as posttraumatic posterolateral ankle pain. Due to high rates of undiagnosed and misdiagnosed cases of LLMB preoperatively, we believe special care should be taken to recognize it during tendoscopy. Peroneal tendoscopy is a high-efficiency, low-complication method to treat some peroneal tendon conditions. Level of Evidence: Level IV, case series.

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“…However, the use of tourniquet is potentially risky; so, working with tourniquet requires care and expertise. Some studies have shown that tourniquet application is not necessary during minimally invasive such as Arthroscopic ankle surgery [5,6]. Tourniquet application has potential risks of improper and even proper use during lower limb surgery, including muscle injury, functional weakness and reduced muscle strength, joint stiffness and postoperative swelling [7,8].…”

Section: Introductionmentioning

confidence: 99%

Effect of Tourniquet Application on Postoperative Outcomes in Minimally Invasive Surgery for Intra-articular Calcaneus Fractures

Zaid¹,

Wu²,

Yang³

et al. 2021

Preprint

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Background: Tourniquets are commonly used during foot and ankle surgery to provide a bloodless operative field and for the sake of the surgeon`s comfort, despite the potential risks associated with it. This study was performed to compare postoperative outcomes of tourniquet-assisted to non-tourniquet-assisted operative fixation of calcaneal fractures.Methods: A total of 131 patients with closed calcaneal fracture who underwent minimally invasive surgery of calcaneal fractures between March 2015 and December 2018 were reviewed retrospectively. Patients for whom a tourniquet was used intraoperatively (n = 62) were compared to those without (n = 69). Operating time and visualization, blood loss, postoperative pain according to visual analogue scale (VAS), the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot score, and hospital length of stay were recorded for all the patients.Results: Statistical analysis of the results showed significant differences between tourniquet and non-tourniquet groups in the mean operation time, visibility of the surgical field, mean estimated intraoperative and postoperative blood loss, and mean VAS pain scores 24 H, 48 H, 72 H postoperatively (P < 0.05), whereas no significant difference between two groups in the mean Serum CPK levels, post-operative swelling, mean length of stay, AOFAS score, wound and fracture healing time, and the mean time for return to work.Conclusion: Our study demonstrated that tourniquet application during minimally invasive surgery of calcaneal fractures can significantly shorten the operation time, improve surgical visualization, and reduce intraoperative blood loss. However, adverse events associated with the use of tourniquet include increased postoperative pain, and more amount of postoperative bleeding. Due to higher postoperative pain and more amount of postoperative bleeding, more attention should be paid on the postoperative phase for those who tourniquet was used. The surgeon's decision to use a tourniquet during calcaneal fractures surgery should be carefully considered.

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Value of Tourniquet Use in Anterior Ankle Arthroscopy: A Randomized Controlled Trial

Abstract: Level I, prospective randomized controlled trial.

Cited by 15 publications

References 21 publications

Effect of Tourniquet Use in Ankle Arthroscopic Surgery on Postoperative Recovery: A Prospective Non- Randomized Controlled Study

Effect of Tourniquet Use in Ankle Arthroscopic Surgery on Postoperative Recovery: A Prospective Non- Randomized Controlled Study

Importance of Space-Occupying Anatomical Variations in Peroneal Tendoscopy

Effect of Tourniquet Application on Postoperative Outcomes in Minimally Invasive Surgery for Intra-articular Calcaneus Fractures

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