Tourniquet used in anterior cruciate ligament reconstruction: a system review

Eur J Orthop Surg Traumatol. 2014 Aug;24(6):999-1003. doi: 10.1007/s00590-013-1351-6. Epub 2013 Nov 13.

Abstract

Purpose: To identify whether routine use of a tourniquet is a better choice for anterior cruciate ligament reconstruction.

Method: We searched Amed, British Nursing Index, Embase, Pubmed, Scopus, Cochrane Library and Google Scholar. We used revised Jadad score to evaluate the trial quality. Each reference list was viewed for any ignored studies. Two reviews independently extracted data from all eligible trials, including study design, patients' characteristics, interventions and outcomes. The available data were using random effects models with mean differences for continuous variables.

Results: The only meta-analysis indicated there was no significant difference in operative time between the tourniquet and non-tourniquet groups (mean differences -5.71, 95 % CI -12.40, 0.99). The remaining outcomes had variations in the outcome measures, so it was not possible to perform meta-analysis.

Conclusions: There was insufficient evidence to support the hypothesis that patients would benefit from routinely applying a tourniquet. More high-quality randomized controlled trials were needed to test the result.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / administration & dosage
  • Anterior Cruciate Ligament Reconstruction / adverse effects
  • Anterior Cruciate Ligament Reconstruction / methods*
  • Blood Loss, Surgical
  • Humans
  • Leg / anatomy & histology
  • Muscle Strength
  • Operative Time
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / etiology
  • Quadriceps Muscle / physiopathology
  • Randomized Controlled Trials as Topic
  • Thigh / anatomy & histology
  • Tourniquets* / adverse effects

Substances

  • Analgesics, Opioid