The effect on leg strength of tourniquet use during anterior cruciate ligament reconstruction: A prospective randomized study

Abstract

Purpose: The purpose of this study was to prospectively evaluate the effect of tourniquet use during endoscopic anterior cruciate ligament (ACL) reconstruction surgery on dorsiflexion strength, plantarflexion strength, quadriceps strength, and calf and thigh girth. Type of Study: The study was a prospective, double-blind, randomized clinical trial. Methods: Forty-eight patients were prospectively randomized into 2 groups: (1) tourniquet use during surgery (T) and, (2) no tourniquet use during surgery (NT). Within 1 week before ACL reconstruction, all patients were evaluated for isometric plantarflexion and dorsiflexion strength, thigh strength, and thigh and calf girth. These same measurements were repeated 3 weeks postoperatively. At 6 months, isokinetic quadriceps strength was evaluated at 60° per second. All patients underwent ACL reconstruction using a patella-tendon autograft and a tourniquet was placed on the affected extremity. In all 25 T patients, the tourniquet was inflated to 300 mm Hg. The average tourniquet time was 85 ± 7 minutes (range, 51 to 114 minutes). Results: ACL reconstruction resulted in a significant decrease in thigh girth (P <.01), calf girth (P <.01), dorsiflexion strength (P <.01), and plantarflexion strength (P <.05) at 3 weeks postoperatively in both groups. The T group had a greater decrease in thigh girth than the NT group (P <.05). Tourniquet use did not have an effect on calf girth (P =.53), dorsiflexion strength (P =.17), or plantarflexion strength (P =.32) at 3 weeks postoperatively. Tourniquet use also had no effect on quadriceps strength at 6 months postoperatively (P =.78). Conclusions: Tourniquet use of less than 114 minutes during ACL reconstruction had no effect on the strength of the lower extremity after surgery.Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 17, No 6 (July-August), 2001: pp 603–607