The impact of tourniquet on tibial bone cement penetration in different zones in primary total knee arthroplasty: a meta-analysis
Abstract Background Cement mantle penetration and the cement–bone interface strength were critical to a successful primary total knee arthroplasty (TKA). It remained unclear whether decreased blood and fat in the cancellous bone achieved with the use of a tourniquet increases tibial cement mantle pe...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-03-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-021-02345-1 |
| _version_ | 1811280919786422272 |
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| author | Changjiao Sun Xin Yang Xiaofei Zhang Qi Ma Peng Yu Xu Cai Yonggang Zhou |
| author_facet | Changjiao Sun Xin Yang Xiaofei Zhang Qi Ma Peng Yu Xu Cai Yonggang Zhou |
| author_sort | Changjiao Sun |
| collection | DOAJ |
| description | Abstract Background Cement mantle penetration and the cement–bone interface strength were critical to a successful primary total knee arthroplasty (TKA). It remained unclear whether decreased blood and fat in the cancellous bone achieved with the use of a tourniquet increases tibial cement mantle penetration in different zones on AP and lateral view in TKA according to criteria defined by the Knee Society Scoring System (KSS). The purpose of this study was to determine whether tourniquet use influences tibial cement mantle penetration in different zones on AP and lateral view in TKA according to KSS. Methods We conducted a meta-analysis to identify studies involving the impact of tourniquet use and no tourniquet use on tibial bone cement penetration in primary TKA in electronic databases, including Web of Science, Embase, PubMed, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CBM, VIP, Wanfang database, up to January 2021. Finally, we identified 1231 patients (1231 knees) assessed in twelve studies. Results Tourniquet use increases the cumulative cement mantle penetration (P < 0.00001), mean cement mantle penetration (P = 0.004), and cement mantle in zone 3(P < 0.0001) on AP view. However, there were no significant differences in cement mantle in zone 1(P = 0.5), zone 2(P =0 .54), zone 4(P = 0.07) on AP view, and zone 1(P = 0.32), zone 2(P = 0.38) on lateral view between two groups. There were also no significant differences in length of surgery(P = 0.7), change in hemoglobin(P = 0.4), transfusion rates(P = 0.47), and complications such as muscular calf vein thrombosis(P = 0.21), superficial infection (P = 0.72), and deep vein thrombosis (P = 0.66) between two groups. Conclusion The application of a tourniquet increases the thickness of the tibial bone cement penetration—the increase in the thickness of bone cement penetration mainly located in zone 3 on the anteroposterior (AP) view. |
| first_indexed | 2024-04-13T01:23:08Z |
| format | Article |
| id | doaj.art-80d18403680f4a5db128589b6858e2f7 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-13T01:23:08Z |
| publishDate | 2021-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-80d18403680f4a5db128589b6858e2f72022-12-22T03:08:42ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-03-0116111310.1186/s13018-021-02345-1The impact of tourniquet on tibial bone cement penetration in different zones in primary total knee arthroplasty: a meta-analysisChangjiao Sun0Xin Yang1Xiaofei Zhang2Qi Ma3Peng Yu4Xu Cai5Yonggang Zhou6Department of Orthopedic, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua UniversityDepartment of Orthopedic, Peking University First HospitalDepartment of Clinical Epidemiology and Biostatistics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua UniversityDepartment of Orthopedic, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua UniversityDepartment of Orthopedic, Wuhan University of Science and Technology HospitalDepartment of Orthopedic, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua UniversityDepartment of Orthopaedic Surgery, The First Medical Centre, Chinese PLA General HospitalAbstract Background Cement mantle penetration and the cement–bone interface strength were critical to a successful primary total knee arthroplasty (TKA). It remained unclear whether decreased blood and fat in the cancellous bone achieved with the use of a tourniquet increases tibial cement mantle penetration in different zones on AP and lateral view in TKA according to criteria defined by the Knee Society Scoring System (KSS). The purpose of this study was to determine whether tourniquet use influences tibial cement mantle penetration in different zones on AP and lateral view in TKA according to KSS. Methods We conducted a meta-analysis to identify studies involving the impact of tourniquet use and no tourniquet use on tibial bone cement penetration in primary TKA in electronic databases, including Web of Science, Embase, PubMed, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CBM, VIP, Wanfang database, up to January 2021. Finally, we identified 1231 patients (1231 knees) assessed in twelve studies. Results Tourniquet use increases the cumulative cement mantle penetration (P < 0.00001), mean cement mantle penetration (P = 0.004), and cement mantle in zone 3(P < 0.0001) on AP view. However, there were no significant differences in cement mantle in zone 1(P = 0.5), zone 2(P =0 .54), zone 4(P = 0.07) on AP view, and zone 1(P = 0.32), zone 2(P = 0.38) on lateral view between two groups. There were also no significant differences in length of surgery(P = 0.7), change in hemoglobin(P = 0.4), transfusion rates(P = 0.47), and complications such as muscular calf vein thrombosis(P = 0.21), superficial infection (P = 0.72), and deep vein thrombosis (P = 0.66) between two groups. Conclusion The application of a tourniquet increases the thickness of the tibial bone cement penetration—the increase in the thickness of bone cement penetration mainly located in zone 3 on the anteroposterior (AP) view.https://doi.org/10.1186/s13018-021-02345-1TourniquetTotal knee arthroplastyCement mantlePenetration |
| spellingShingle | Changjiao Sun Xin Yang Xiaofei Zhang Qi Ma Peng Yu Xu Cai Yonggang Zhou The impact of tourniquet on tibial bone cement penetration in different zones in primary total knee arthroplasty: a meta-analysis Journal of Orthopaedic Surgery and Research Tourniquet Total knee arthroplasty Cement mantle Penetration |
| title | The impact of tourniquet on tibial bone cement penetration in different zones in primary total knee arthroplasty: a meta-analysis |
| title_full | The impact of tourniquet on tibial bone cement penetration in different zones in primary total knee arthroplasty: a meta-analysis |
| title_fullStr | The impact of tourniquet on tibial bone cement penetration in different zones in primary total knee arthroplasty: a meta-analysis |
| title_full_unstemmed | The impact of tourniquet on tibial bone cement penetration in different zones in primary total knee arthroplasty: a meta-analysis |
| title_short | The impact of tourniquet on tibial bone cement penetration in different zones in primary total knee arthroplasty: a meta-analysis |
| title_sort | impact of tourniquet on tibial bone cement penetration in different zones in primary total knee arthroplasty a meta analysis |
| topic | Tourniquet Total knee arthroplasty Cement mantle Penetration |
| url | https://doi.org/10.1186/s13018-021-02345-1 |
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