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The Effect of Tourniquet Use in Anterior Cruciate Ligament Reconstruction

A Prospective, Randomized Study

Orthopaedic Service, Keller Army Community Hospital, West Point, New York

Charles R. Scoville, LTC, MPT

Orthopaedic Service, Keller Army Community Hospital, West Point, New York

Roman A. Hayda, MAJ, MC, USA

Orthopaedic Service, Keller Army Community Hospital, West Point, New York

Robert J. Snyder, MD

Orthopaedic Service, Keller Army Community Hospital, West Point, New York

To evaluate the effect of tourniquet use during anterior cruciate ligament reconstruction, 40 consecutive pa tients were randomized into two groups: Group I (tour niquet) and Group II (no tourniquet). Preoperative eval uation included electromyography, measurement of thigh and calf girth, and determination of serum creat inine phosphokinase levels. Initial postoperative eval uations included serial creatinine phosphokinase de terminations. At 1 and 6 months postoperatively, the electromyographic examination was repeated and thigh and calf girth measurements were obtained. At 6 months and 1 year after surgery, the following evalu ations were made: thigh and calf girth, KT-1000 arthro metric testing, isokinetic testing of quadriceps and hamstring muscles, single-legged hop test for time, single-legged hop test for distance, and the Lysholm knee score. In Group I, the tourniquet was inflated for an average of 87 minutes, with an average pressure of 269 mm Hg. At 1 month postoperatively, 6 of 20 pa tients in Group I had positive electromyographic re cordings (compared with 2 of 20 in Group II, P = 0.08). At 1 month, thigh girths measured 10 cm proximal to the medial joint line suggested more atrophy in the tourniquet group ( P = 0.07). At 6 months, all electro myographic recordings had returned to normal. At 6 months and 1 year postoperatively, girth meas urements, isokinetic strength testing, functional testing, KT-1000 arthrometer evaluation, and the Lysholm knee scores were similar for both groups.

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