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Not using a tourniquet is superior to tourniquet use for high tibial osteotomy: a prospective, randomised controlled trial

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A Correction to this article was published on 19 January 2022

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Abstract

Purpose

Tourniquets are routinely used in high tibial osteotomy (HTO). However, research on the necessity of tourniquets during HTO is lacking. This study was designed to investigate the necessity of tourniquets in HTO.

Methods

This was a prospective study that included patients who underwent HTO at the same hospital. The patients were randomised into Group A (non-tourniquet, n = 45) and Group B (tourniquet, n = 45). Same surgical techniques and haemostatic methods were used in the two groups.

Results

All patients were followed up for more than three months. There was no difference in operation time, and no intra-operative vascular or nerve damage occurred in either group. The hospital stay was shorter in group A than in group B (p < 0.05). There was no difference in post-operative blood loss, haemoglobin or haematocrit (p > 0.05). The post-operative visual analogue scale (VAS) pain scores and calf swelling were lower in group A (p < 0.05), and the early knee range of motion was higher in group A (p < 0.05). The use of morphine and the incidence of thigh complications were also lower in group A (p < 0.05). There was no difference in the VAS and knee function between the two groups at three months post-operatively (p > 0.05).

Conclusion

Tourniquet use during HTO does not reduce post-operative blood loss, operation time or intra-operative complications, but not using a tourniquet shortens the hospital stay and reduces the post-operative usage of morphine and tourniquet-related complications, which promotes early recovery of knee function.

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Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors are grateful to the patients that were willing to participate in the study.

Funding

This work was funded by the Natural Science Foundation of Shandong Province (ZR2020MH278), the Horizontal project of Shandong University (12671818) and the Rongxiang Regenerative Medicine Foundation of Shandong University (2019SDRX-17).

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China

    Songlin Li & Wenwei Qian

  2. Department of Orthopedics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China

    Songlin Li, Qunshan Lu, Yang Yu, Zhuang Miao, Desu Luo, Kaifei Han, Lei Li & Peilai Liu

  3. Department of Orthopedics, Shenxian Central Hospital of Shandong Province, Liaocheng, Shandong, China

    Xiangshuai Zhang

  4. Department of Orthopedics, Zibo Boshan District Hospital of Traditional Chinese Medicine, Zibo, Shandong, China

    Mingxing Liu

Authors
  1. Songlin Li
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Contributions

All authors contributed to either the conception, design, data collection or analysis. Songlin Li, Wenwei Qian and Peilai Liu were responsible for conception and design of the study. Songlin Li, Xiangshuai Zhang and Qunshan Lu drafted the manuscript. Mingxing Liu, Desu Luo, Kaifei Han and Lei Li contributed to data collection. Songlin Li, Mingxing Liu, YangYu and Zhuang Miao contributed to manuscript preparation and data analysis. Peilai Liu and Wenwei Qian contributed to revision of the manuscript. All authors read and approved the final manuscript. Wenwei Qian and Peilai Liu contribute equally to the work and should be regarded as co-corresponding authors.

Corresponding author

Correspondence to Peilai Liu.

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This trial was approved by the ethics committee of a local hospital (KYLL-2019042) and registered at ClinicalTrials.gov, number NCT-04992533.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

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Li, S., Zhang, X., Liu, M. et al. Not using a tourniquet is superior to tourniquet use for high tibial osteotomy: a prospective, randomised controlled trial. International Orthopaedics (SICOT) 46, 823–829 (2022). https://doi.org/10.1007/s00264-021-05246-4

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