title: [A meta-analysis for the efficacy and safety of tourniquet in total knee arthroplasty].
abstract: OBJECTIVE
  To evaluate the efficacy and safety of tourniquet in total knee arthroplasty.
  
  
  METHODS
  Studies on comparison between with and without tourniquet in total knee arthroplasty were identified from Medline, PubMed, EMASE, Cochrane Library, CBM, Highwire, CNKI, VIP, Articles Digital Periodicals.All the randomized controlled trials were included for meta-analysis with RevMan 4.2.2 software.
  
  
  RESULTS
  Nineteen studies involving 15 in foreign languages, 4 in Chinese were identified. There were 1159 cases of knee replacement patients. The results of meta-analysis indicated that there were statistical difference between two groups on intraoperative blood loss (P = 0.000), the number of deep venous thrombosis (P = 0.020), thigh pain (P = 0.000), knee hematoma (P = 0.030), wound infection (P = 0.040), skin ecchymosis area (P = 0.000), and the increasing rate of knee circumference of 3 days after the operation (P = 0.000), while there were no statistical differences with respect to the total blood loss (P = 0.100), the number of blood transfusions (P = 0.150), operation time (P = 0.120), length of hospital stay (P = 0.350), the number of pulmonary embolism (P = 0.310), and skin blisters (P = 0.170).
  
  
  CONCLUSIONS
  The tourniquet for total knee arthroplasty can reduce intraoperative blood loss, but can not reduce total blood loss and the number of blood transfusions transfusion, can not improve operative efficiency, can not shorten the hospitalization time and promote the knee joint functional recovery. Furthermore the tourniquet increases the probability of occurrence on deep vein thrombosis, wound infection, hematoma and ecchymosis knee, it also causes knee swelling and thigh pain. It suggests minimize to use tourniquet in total knee arthroplasty.
authors.affiliation: Department of Orthpaedics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China.
authors.forename: Tao
authors.initials: T
authors.lastname: He
authors.forename: Li
authors.initials: L
authors.lastname: Cao
authors.forename: De-sheng
authors.initials: DS
authors.lastname: Yang
authors.forename: De-li
authors.initials: DL
authors.lastname: A
authors.forename: Bo-yong
authors.initials: BY
authors.lastname: Xu
authors.forename: Guo-qing
authors.initials: GQ
authors.lastname: Li
authors.forename: Hu
authors.initials: H
authors.lastname: Chen
authors.forename: Yun
authors.initials: Y
authors.lastname: Zeng
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D012449:Safety; D014111:Tourniquets / Q000009:adverse effects*