Anterior cruciate ligament reconstruction; is a tourniquet necessary? A randomized controlled trial

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
Walid RedaMahmoud Abdel Karim

Abstract

This work aimed at studying the effect of tourniquet use on surgical performance and peri-operative outcomes of anatomic single-bundle ACL reconstruction. Eighty-four patients undergoing ACL surgery were randomized into two groups: the tourniquet (A) group and the non-tourniquet (B) group. Post-operative pain, need for analgesics, the volume of blood obtained in the drain, girth diameter changes in the thigh and calf, muscle strength and amount of haemarthrosis were used as outcome measures to compare the two groups. Fifty-eight patients were available for analysis. In the A group, the degree of pain and need to analgesics was significantly higher at 4 and 10 h. The volume measured in the surgical drain, at 24 h post-operative, was higher in the A group (p = 0.001). The calf and thigh girth diameters at 2 weeks showed a highly significant girth difference between the two groups (p = 0.001). This study showed that tourniquet use in ACL reconstruction increases immediate post-operative symptoms of pain and haemarthrosis and that the effects on muscle strength are only temporary. The tourniquet can be replaced by using of a mixture of morphine and adrenaline with no interference with the quality of visibility, nor operative time. I.

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Citations

Aug 5, 2016·Journal of Clinical Orthopaedics and Trauma·Raju VaishyaVipul Vijay
Nov 2, 2018·Annals of the Royal College of Surgeons of England·K M Yaghmour, H Al-Khateeb
Jul 16, 2020·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Akinori KaneguchiKaoru Yamaoka
Dec 2, 2017·Orthopedics·David E HartiganBenjamin G Domb
Apr 20, 2019·Orthopaedic Journal of Sports Medicine·Avinesh AgarwallaBrian Forsythe
Apr 2, 2021·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Muhamed M Farhan-AlaniePeter D H Wall
May 1, 2021·Indian Journal of Orthopaedics·Abhay ChoudharyAmarjeet Singh
May 4, 2021·Revista Brasileira De Ortopedia·Iberê Pereira Datti
May 4, 2021·The Bone & Joint Journal·Ahmed A Magan, Fares S Haddad

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