19:26 PM

Tourniquet use may increase risk for serious adverse events after knee replacement

Orthopedics Today highlights the perspective of Jose A. Rodriguez, MD, hip and knee surgeon at HSS, on study findings showing the use of a tourniquet in knee replacement surgery may increase the risk for serious adverse events and may be associated with higher postoperative pain.

Dr. Rodriguez wrote, “This Cochran Library systematic review is designed to consider all published, randomized controlled studies and large cohort studies that address the specific question of tourniquet use in TKA. The value of this review lies in both the rigor of the analysis and the concerted effort to consider the bias of each study based on its scientific design. The authors breakdown the specific outcome measures, such as early pain, function, adverse events, etc., which is most useful. Based on these mostly short-term outcome measures, the authors conclude that surgery with a tourniquet does not confer meaningful clinical benefit.”

He added, “The deficiency in this analysis lies in the fact that tourniquet use is meant to clear the surgical field for expeditious surgery and, more importantly, optimal cement penetration into the cancellous bone for long-term fixation and durability of the arthroplasty. As such, the primary outcome of the use of the tourniquet is not being assessed in this short-term analysis.”

Dr. Rodriguez concluded, “With increasing use of non-cemented implants, where clean bony surfaces offer no benefit, the value and applicability of these finding will become more evident.”

Read the full article at Healio.com/news/orthopedics.