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.
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.
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.
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.
Who cites it
15 citing papers in PubMed, 4 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Total knee arthroplasty with or without a tourniquet: a meta-analysis of randomized controlled trials.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Pooled it
- Physical exercise improved muscle strength and pain on neck and shoulder in military pilots.Frontiers in physiology · 2022Pooled it
- Association Between Vitamin D Supplementation and Fall Prevention.Frontiers in endocrinology · 2022Pooled it
- Clinical Efficacy and Safety of Surgical Treatments in Patients With Pure Cervical Radiculopathy.Frontiers in public health · 2022Pooled it
- Effect of hyperbaric oxygen therapy on postoperative muscle damage and inflammation following total knee arthroplasty: a randomized controlled trial.Scientific reports · 2025Trial
- The use of tourniquet in total knee arthroplasty does not impact the functional outcome: a randomised controlled study.Journal of orthopaedic surgery and research · 2024Trial
- Programmed intermittent adductor hiatus block enhances early recovery after total knee arthroplasty: a randomized controlled trial.Arthroplasty (London, England) · 2026Article
- The effect of silicone ring tourniquet in anterior cruciate ligament reconstruction: a retrospective comparative study.BMC musculoskeletal disorders · 2026Article
- Comparison of perioperative analgesia between posterior stabilized and posterior cruciate retaining prostheses following total knee arthroplasty.Scientific reports · 2025Article
- Article
- The status and hotspot analysis of research on extracellular vesicles and osteoarthritis: a bibliometric analysis.Frontiers in pharmacology · 2025Review
- Is outpatient joint arthroplasty safe in a high volume academic centre? A retrospective monocentric study using an institutional pathway.International orthopaedics · 2024Article
- Impact of fast-track surgery on perioperative care in patients undergoing hepatobiliary surgery.World journal of gastrointestinal surgery · 2024Article
- Are we causing early undesirable situations by using a tourniquet in total knee arthroplasty?Joint diseases and related surgery · 2024Article
- Decompression alone or decompression and fusion in degenerative lumbar spondylolisthesis.EClinicalMedicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
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.
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Registered trials
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.