The Use Or Not Use Of Pneumatic Tourniquet In Total Knee Arthroplasty: A Meta-analysis

Background: Pneumatic tourniquet use in total knee arthroplasty (TKA) isalways a controversial issue. The aim of the present study is to assess the effectivenessand safety of its use in patients receiving primary unilateral TKA, and to explore themost safe and effective protocols.Materials and Methods: Only randomized controlled trials (RCTs) wereeligible for this study. The participants were adults who had undergone primaryunilateral TKA. The Review Manager Database (RevMan version5.0, The CochraneCollaboration2008) was used to analyze the dates of the selected studies.Results: Thirteen RCTs involving859patients were included in this analysis.The use of tourniquet could significantly reduce operation time (mean difference-5.01minutes, P=0.003) and intraoperative blood loss (mean difference-201.85ml, P<0.00001). But postoperative (mean difference45.99ml, P=0.68) as well as totalblood loss volumes (mean difference192.25ml, P=0.37) were slightly increased inthat situation. With respect to surgical complications, a tendency of increasing riskratio was observed for tourniquet group.Conclusions: Our results indicate that tourniquet application could reducesurgical time and intraoperative blood loss, but increases postoperative and total bloodloss. With respect to postoperative complications, DVT and surgical site infection ratesare relatively augmented in the tourniquet group.