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

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This work aimed at studying the effect of tourniquet use on surgical performance and peri-operative outcomes of anatomic single-bundle ACL reconstruction.

Methods

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.

Results

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).

Conclusion

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.

Level of evidence

I.

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Conflict of interest

All authors certify not having received any benefits or funding from any commercial organization related to this study.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt

    Walid Reda & Mahmoud Abdel Karim

  2. Department of Orthopedic Surgery, Faculty of Medicine, Fayoum University, Elfayoum, Egypt

    Ahmed Mahmoud Fouad ElGuindy

  3. Department of Anaesthesia, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt

    Gomoa Zahry

  4. Department of Physical Therapy for Musculoskeletal Disorders, Faculty of Physical Therapy, Beni Suef University, Beni Suef, Egypt

    Mona Selim Faggal

Authors
  1. Walid Reda
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  2. Ahmed Mahmoud Fouad ElGuindy
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  3. Gomoa Zahry
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  4. Mona Selim Faggal
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  5. Mahmoud Abdel Karim
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Corresponding author

Correspondence to Ahmed Mahmoud Fouad ElGuindy.

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Reda, W., ElGuindy, A.M.F., Zahry, G. et al. Anterior cruciate ligament reconstruction; is a tourniquet necessary? A randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 24, 2948–2952 (2016). https://doi.org/10.1007/s00167-015-3582-z

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  • DOI: https://doi.org/10.1007/s00167-015-3582-z

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