• D S Johnson, H Stewart, P Hirst, and N J Harper.
• Department of Orthopaedics, Manchester Royal Infirmary, Manchester, England. David.Johnson@nwota.demon.co.uk
• Arthroscopy. 2000 Sep 1; 16 (6): 648-51.

PurposeWith 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.Type Of StudyWe performed a prospective randomized trial on 109 patients undergoing knee arthroscopy.Materials And MethodsAll 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.ResultsThe 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.ConclusionsMany 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.

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