Journal
KNEE
Volume 17, Issue 2, Pages 141-147Publisher
ELSEVIER
DOI: 10.1016/j.knee.2009.06.007
Keywords
Tourniquet; Total knee replacement; Meta-analysis; Blood loss
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Proponents Of tourniquets Postulate that they optimise intra-operative visibility and reduce blood loss. This study compared the outcomes of tourniquet assisted to non-tourniquet assisted total knee replacement (TKR). A systematic review Was undertaken of the electronic databases Medline, CINAHL, AMED and EMBASE, in addition to a review of unpublished material and a hand search of pertinent orthopaedic journals. The evidence-base was critically appraised using a tool from the Cochrane Bone, joint and Muscle Trauma Group. Fifteen studies were identified evaluating 16 Outcome measures and parameters of 1040 TKRs in 991 patients. There was a significantly greater intra-operative blood loss in non-tourniquet compared to tourniquet assisted surgery (p=0.004). There was no significant difference between the groups for total blood loss or transfusion Fate (p=0.22; p=0.48). There was a trend for greater complications in tourniquet compared to non-tourniquet patients. There was no difference between the groups for any other Outcome measure assessed. In conclusion, this systematic review has found that there is no advantage to using a tourniquet in knee replacement surgery for reduction of transfusion requirements. (C) 2009 Elsevier B.V. All rights reserved.
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