ReviewCureus2025
The Hidden Costs of a Bloodless Field: A Systematic Review of the Complications of Tourniquet Use in Total Knee Arthroplasty.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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
1 citing paper in PubMed.
- Tourniquet use in total knee arthroplasty and systemic inflammation: a retrospective cohort study.BMC musculoskeletal disorders · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Pneumatic tourniquets are widely used in total knee arthroplasty (TKA) to improve visualization and cement fixation, yet their potential harms remain debated. This study systematically evaluated complications associated with tourniquet use in primary TKA, focusing on wound complications as the primary outcome and venous thromboembolism (VTE), pain, quadriceps dysfunction, transfusion, and systemic adverse events as secondary outcomes. MEDLINE (Medical Literature Analysis and Retrieval System Online), Embase, and Cochrane Controlled Register of Trials (CENTRAL) were searched from January 2000 to July 2025. Eligible randomized controlled trials (RCTs) compared (i) tourniquet vs no tourniquet, (ii) full-duration vs limited/timed use, or (iii) alternative pressure strategies. Two reviewers independently screened, extracted data, and assessed risk of bias (RoB 2). Random-effects meta-analyses were performed where appropriate. Certainty of evidence was appraised using GRADE (Grading of Recommendations, Assessment, Development, and Evaluations). Twenty-six reports (25 unique RCT datasets; 3,183 patients, 2001-2024) were included. Across 1,940 patients in 15 RCT comparisons, tourniquet use showed a non-significant trend toward more wound complications (risk ratio (RR) 1.31, 95%CI 0.73-2.36; moderate certainty, I²=20.9%). VTE across 2,144 patients in 15 RCTs showed no significant difference (RR 1.09, 95%CI 0.72-1.64; low certainty). Transfusion in three RCTs (199 patients) showed no clear difference (RR 0.45, 95%CI 0.19-1.04; low certainty). Six RCTs (~500 patients) consistently reported greater early pain and quadriceps dysfunction with tourniquet. Rare but serious adverse events (e.g., compartment syndrome, vascular injury) were documented. In primary TKA, routine full-duration tourniquet use does not reduce VTE or transfusion requirements, is associated with early pain and quadriceps dysfunction, and may increase wound morbidity. Pressure-optimised or selective approaches may mitigate harms while preserving technical benefits. Routine use should be reconsidered in favour of tailored strategies.
Indexed as
Identifiers
What Socratic holds
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.