Does ACL reconstruction without a thigh tourniquet reduce pain?

  • Research type

    Research Study

  • Full title

    Does ACL reconstruction without a thigh tourniquet tourniquet reduce pain and improve rehabilitation? A randomised controlled trial.

  • IRAS ID

    154380

  • Contact name

    Hugo C Guthrie

  • Contact email

    hugoguthrie@doctors.org.uk

  • Sponsor organisation

    Jonathan Webb Clinic

  • Research summary

    This trial compares our current practice of using a thigh tourniquet inflated to 300mmHg throughout arthroscopic ACL reconstruction to the same procedure performed without a tourniquet. A standardised surgical method using hamstring tendon graft and general anaesthetic technique will be used in both groups. In both groups intra-articular bleeding will be reduced by injection of local anaesthetic with epinephrine (20mls Marcain 0.5% with Epinephrine 1:200,000) prior to surgery and use of ArthroWand (Arthrocare UK, Knaresborough, UK) to coagulate bleeding vessels during surgery.

    Intra-operative opiate analgesia will be given in small aliquots in response to variation in physiological parameters by an anaesthetist (who will be blinded to tourniquet use) and this will be recorded. Post-operative opiate analgesia will be by PCA (patient will be blinded to tourniquet use) and use will be recorded. Pain scores (Visual analogue scale) will be recorded in recovery, on return to the ward, prior to discharge and at around 2 weeks (nurse recording pain scores will be blinded to tourniquet use). Thigh muscle bulk and power and knee range of movement will be measured at out-patient follow-up appointments (physiotherapist will be blinded to tourniquet use).

    The data will be compared to determine if there is a significant difference in opiate use, post-operative pain scores, muscle bulk, knee extension power and knee range of movement.

  • REC name

    South West - Frenchay Research Ethics Committee

  • REC reference

    14/SW/1053

  • Date of REC Opinion

    10 Oct 2014

  • REC opinion

    Further Information Favourable Opinion