Evidence mapPaperPMID 35359779Full record

SynthesisFrontiers in public health2022

Association of Use of Tourniquets During Total Knee Arthroplasty in the Elderly Patients With Post-operative Pain and Return to Function.

Jian Zhao, Xin Dong, Ziru Zhang, Quanyou Gao, Yunfei Zhang, Junlei Song, Shun Niu, Tian Li, Jiying Chen, Fei-Long Wei

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in Frontiers in public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 4 pooled it
1.4field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 4 syntheses or guidelines pooled it, 20 citations in OpenAlex.

  1. Total knee arthroplasty with or without a tourniquet: a meta-analysis of randomized controlled trials.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Jian ZhaoDepartment of Orthopedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
Xin DongDepartment of Orthopedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
Ziru ZhangDepartment of Orthopedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
Quanyou GaoDepartment of Orthopedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
Yunfei ZhangDepartment of Orthopedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
Junlei SongDepartment of Orthopedics, The First Medical Center, Chinese PLA General Hospital (301 Hospital), Beijing, China.
Shun NiuDepartment of Orthopedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
Tian LiSchool of Basic Medicine, Fourth Military Medical University, Xi'an, China.
Jiying ChenDepartment of Orthopedics, The First Medical Center, Chinese PLA General Hospital (301 Hospital), Beijing, China.
Fei-Long WeiDepartment of Orthopedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
Air Force Medical University · CNChinese PLA General Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: During total knee arthroplasty (TKA), tourniquet may negatively impact post-operative functional recovery. This study aimed at investigating the effects of tourniquet on pain and return to function. Methods: Pubmed, Embase, and Cochrane Library were comprehensively searched for randomized controlled trials (RCTs) published up to February 15th, 2020. Search terms included; total knee arthroplasty, tourniquet, and randomized controlled trial. RCTs evaluating the efficacies of tourniquet during and after operation were selected. Two reviewers independently extracted the data. Effect estimates with 95% CIs were pooled using the random-effects model. Dichotomous data were calculated as relative risks (RR) with 95% confidence intervals (CI). Mean differences (MD) with 95% CI were used to measure the impact of consecutive results. Primary outcomes were the range of motion (ROM) and visual analog scale (VAS) pain scores. Results: Thirty-three RCTs involving a total of 2,393 patients were included in this study. The mean age is 65.58 years old. Compared to no tourniquet group, the use of a tourniquet resulted in suppressed ROM on the 3rd post-operative day [MD, -4.67; (95% CI, -8.00 to -1.35)] and the 1st post-operative month [MD, -3.18; (95% CI, -5.92 to -0.44)]. Pain increased significantly when using tourniquets on the third day after surgery [MD, 0.39; (95% CI, -0.19 to 0.59)]. Moreover, tourniquets can reduce intra-operative blood loss [MD, -127.67; (95% CI, -186.83 to -68.50)], shorter operation time [MD, -3.73; (95% CI, -5.98 to -1.48)], lower transfusion rate [RR, 0.85; (95% CI, 0.73-1.00)], higher superficial wound infection rates RR, 2.43; [(5% CI, 1.04-5.67)] and higher all complication rates [RR, 1.98; (95% CI, 1.22-3.22)]. Conclusion: Moderate certainty evidence shows that the use of a tourniquet was associated with an increased risk of higher superficial wound infection rates and all complication rates. Therefore, the findings did not support the routine use of a tourniquet during TKA.

Indexed as

Arthroplasty, Replacement, KneePostoperative PainTourniquetsAgedHumansRandomized Controlled Trials as TopicRange of Motion, Articularelderfunctionpaintotal knee arthroplastytourniquet

Identifiers

PMID35359779
PMCPMC8960992
OpenAlexW4220702046

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.