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

Purpose: The purpose of this study was to prospectively evaluate the effect of tourniquet use during endoscopic anterior cruciate ligament (ACL) recon struction surgery on dorsiflexion strength, plantarflexion strength, quadri ceps strength, and calf and thigh girth. Type of Study: The study was a pro spective, double-blind, randomized clinical trial. Methods: Forty-eight pat ients were prospectively randomized into 2 groups: (1) tourniquet use durin g surgery (T) and, (2) no tourniquet use during surgery (NT). Within 1 week before ACL reconstruction, all patients were evaluated for isometric plant arflexion and dorsiflexion strength, thigh strength, and thigh and calf gir th. These same measurements were repeated 3 weeks postoperatively. At 6 mon ths, isokinetic quadriceps strength was evaluated at 60 degrees 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 patient s, the tourniquet was inflated to 300 mm Hg. The average tourniquet time wa s 85 +/-7 minutes (range, 51 to 114 minutes). Results: ACL reconstruction r esulted 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 decre ase 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 planta rflexion 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 reconstruct ion had no effect on the strength of the lower extremity after surgery.