{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T23:13:38Z","timestamp":1778714018035,"version":"3.51.4"},"reference-count":36,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Tourniquet is frequently used during total knee arthroplasty (TKA); however, its use is associated with increased pain, reduced function, and increased swelling in the early postoperative period. This study aims to evaluate the effects of tourniquet application on swelling, pain, knee function, and patient-reported outcomes. This nonrandomized single-center observational clinical trial included 84 primary TKAs, with assessment of tourniquet duration (minutes) and tourniquet pressure (mmHg). Swelling was quantitatively assessed through multiple circumferential measurements of the leg. Secondary outcome included pain intensity, knee flexion, and the Western Ontario and McMaster Universities Osteoarthritis Index score. Outcome was measured at multiple time points before TKA until 6 weeks after TKA. Overall swelling was less at 5 days (3.9\u2009\u00b1\u20090.75 L vs. 4.7\u2009\u00b1\u20091.0\u2009L; p\u2009=\u20090.004) with low tourniquet pressure. The level of pain after surgery was lower in the tourniquet cementation group both at 2 days (2.9\u2009\u00b1\u20092.1 vs. 4.7\u2009\u00b1\u20092.5, p\u2009=\u20090.01) and at 5 days (2.7\u2009\u00b1\u20092.1 vs. 4.2\u2009\u00b1\u20092.5, p\u2009=\u20090.02) after surgery. Active knee flexion at 5 days after surgery was less with longer tourniquet application (65.4\u2009\u00b1\u200916.4 vs. 74.4\u2009\u00b1\u200916.7, p\u2009=\u20090.04). We recommend keeping the tourniquet cuff pressure around the thigh below 300\u2009mm Hg to reduce swelling of the whole leg in the early postoperative period after TKA. Tourniquet duration should be kept as low as possible, ideally only during the cementation period, resulting in clinically relevant decreased postoperative pain and increased postoperative knee range of motion. In cases that require higher tourniquet pressures or longer duration of tourniquet, complete recovery from all negative effects can be expected at 6 weeks following TKA. The study provides therapeutic level III evidence.<\/jats:p>","DOI":"10.1055\/a-2865-2700","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:40:28Z","timestamp":1777588828000},"source":"Crossref","is-referenced-by-count":0,"title":["Assessment of Swelling, Function, and Pain Following the Tourniquet Use in Total Knee Arthroplasty"],"prefix":"10.1055","clinical-trial-number":[{"clinical-trial-number":"nct05119764","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5045-1374","authenticated-orcid":false,"given":"Moritz","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Paracelsus Medical University Salzburg, Salzburg, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard A.","family":"Lindtner","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Medical University of Innsbruck, Innsbruck, Tirol, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Eichinger","sequence":"additional","affiliation":[{"name":"Department for Orthopedics and Traumatology, BKH St. Johann in Tyrol, St. Johann in Tirol, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franz","family":"Endstrasser","sequence":"additional","affiliation":[{"name":"Department for Orthopedics and Traumatology, BKH St. Johann in Tyrol, St. Johann in Tirol, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannes","family":"Sch\u00f6nthaler","sequence":"additional","affiliation":[{"name":"Department for Orthopedics and Traumatology, BKH St. Johann in Tyrol, St. Johann in Tirol, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Pedross","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Tyrolean Federal Institute for Integrated Care, Innsbruck, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Brunner","sequence":"additional","affiliation":[{"name":"Department for Orthopedics and Traumatology, BKH St. Johann in Tyrol, St. Johann in Tirol, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"issue":"08","key":"ref1","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1055\/s-0039-1681035","article-title":"Tourniquet use in total knee arthroplasty","volume":"32","author":"J R Arthur","year":"2019","journal-title":"J Knee Surg"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"2877","DOI":"10.1007\/s00402-022-04470-w","article-title":"The effects of tourniquet on cement penetration in total knee arthroplasty","volume":"143","author":"S G Zak","year":"2023","journal-title":"Arch Orthop Trauma Surg"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1055\/s-0041-1740926","article-title":"A randomized controlled study on the use of tourniquet in primary total knee arthroplasty","volume":"35","author":"C Zhang","year":"2022","journal-title":"J Knee Surg"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1055\/s-0041-1731719","article-title":"Effects of the use of tourniquet in total knee arthroplasty on the clinical and functional outcomes with 5 years of follow-up: a randomized controlled trial","volume":"36","author":"S A Hamawandi","year":"2023","journal-title":"J Knee Surg"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1186\/s12891-019-2636-7","article-title":"Is lower tourniquet pressure during total knee arthroplasty effective? 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