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《Chinese Journal of Bone and Joint Injury》 2017-08
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Application of a tourniquet in total knee arthroplasty, advantages vs disadvantages:a systematic review and meta-analysis of randomized controlled studies

DU Chuan-chao;QIU Hai-bin;ZHANG Heng;WANG Zhan-chang;XU Jian-biao;Department of Orthopaedic, First Hospital of Tsinghua University;  
Objective To evaluate the advantages and disadvantages of applying the tourniquet in total knee arthroplasty(TKA). Methods According to Cochrane intervention system evaluation handbook(version 5.00), keywords, knee replacement and tourniquet were searched in the databases EMBASE database and Medline database. Data of the operation time, intraoperative blood loss, total perioperative blood loss, deep vein thrombosis and pulmonary embolism were collected in TKA patients with tourniquet or not, then further analyzed through a systematic review and Meta analysis. Results Ten random controlled studies, 493 patients, were selected. Tourniquet group 249 patients, male 65, female 184; Non-tourniquet group 244 patients, male 69, female 175. There was no significant difference in operation time( P 0.05), however, applying a tourniquet could significantly reduce the volume of total perioperative blood loss and intraoperative blood loss( P 0.01).Conclusion The results showed that application of tourniquets can reduce the intraoperative blood loss and total perioperative blood loss. However, patients with tourniquet in TKA suffered higher complications such as DVT, PE, injury of soft tissue, blood vessels, and nerves.
【Key Words】: Total knee arthroplasty Tourniquet Systematic review Meta-analysis
【CateGory Index】: R687.4
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