Is tourniquet use necessary for knee arthroscopy?

Purpose: With several studies identifying the tourniquet as a factor for in creased risk of complications in knee arthroscopy, we wished to identify wh ether its use is necessary. Type of Study: We performed a prospective rando mized trial on 109 patients undergoing knee arthroscopy. Materials and Meth ods: All patients had a tourniquet placed on the thigh and were assigned to either have it inflated or not inflated. Personal information, operative d erails, postoperative pain scores, analgesic requirements, and complication s were recorded. Results: The 2 groups were comparable. There was no signif icant difference between the 2 groups with respect to operative view, durat ion of operation, pain scores, analgesic requirements, or complications. Th e tourniquet required intraoperative inflation in 4 patients assigned not t o have it inflated; in 1 patient, the tourniquet made no difference to the operative view. Conclusions: Many orthopaedic units continue to use a tourn iquet routinely for knee arthroscopy, probably in the belief that a clear o perative view can only be achieved with one. However, the findings in our t rial 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.