Is tourniquet use necessary for knee arthroscopy?
OBJECTIVE
With several studies identifying the tourniquet as a factor for increased risk of complications in knee arthroscopy, we wished to identify whether its use is necessary.


METHODS
We performed a prospective randomized trial on 109 patients undergoing knee arthroscopy.


METHODS
All patients had a tourniquet placed on the thigh and were assigned to either have it inflated or not inflated. Personal information, operative details, postoperative pain scores, analgesic requirements, and complications were recorded.


RESULTS
The 2 groups were comparable. There was no significant difference between the 2 groups with respect to operative view, duration of operation, pain scores, analgesic requirements, or complications. The tourniquet required intraoperative inflation in 4 patients assigned not to have it inflated; in 1 patient, the tourniquet made no difference to the operative view.


CONCLUSIONS
Many orthopaedic units continue to use a tourniquet routinely for knee arthroscopy, probably in the belief that a clear operative view can only be achieved with one. However, the findings in our trial indicate that knee arthroscopy may be performed adequately without the use of a tourniquet. Therefore, we recommend that its routine use for this procedure is discontinued.
Johnson
D S
DS
Department of Orthopaedics, Manchester Royal Infirmary, Manchester, England. David.Johnson@nwota.demon.co.uk
Stewart
H
H
Hirst
P
P
Harper
N J
NJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D007717:Knee / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D014111:Tourniquets / Q000009:adverse effects*