The Journal of Bone and Joint Surgery (American). 2009;91:2958-2967.
doi:10.2106/JBJS.I.00634
© 2009 The Journal of Bone and Joint Surgery, Inc.
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Current Concepts Review

Surgical Tourniquets in Orthopaedics

Shahryar Noordin, MBBS, FCPS1, James A. McEwen, PhD, PEng2, Colonel John F. Kragh, Jr., MD3, Andrew Eisen, MD, FRCPC4 and Bassam A. Masri, MD, FRCSC2

1 Section of Orthopaedics, Department of Surgery, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan. E-mail address: shahryar.noordin{at}aku.edu
2 Division of Lower Limb Reconstruction and Oncology, Department of Orthopaedics (J.A.McE., and B.A.M.), and Department of Electrical and Computer Engineering (J.A.McE.), University of British Columbia, 3114, 910 West 10th Avenue, Vancouver, V5Z 4E3 BC, Canada
3 United States Army Institute of Surgical Research, Regenerative Medicine, 3400 Rawley East Chambers Avenue, Building 3611, Room L82-16, Fort Sam Houston, TX 78234-6315
4 Department of Neurology, University of British Columbia, 2862 Highbury Street, Vancouver, V6R 3T6 BC, Canada

Investigation performed at the Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Disclaimer: The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of Defense or United States Government.

Higher levels of tourniquet pressure and higher pressure gradients beneath tourniquet cuffs are associated with a higher risk of nerve-related injury.

Measurement of limb occlusion pressure can help to minimize tourniquet pressure levels and pressure gradients for individual patients and individual surgical procedures.

Selective use of pneumatic, wider, and contoured tourniquet cuffs reduces tourniquet pressure levels and the applied pressure gradients.


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Letters to the Editor:

Read all Letters to the Editor

Response to Surgical Tourniquets in Orthopaedics
Noam Gavriely, MD, DSc
JBJS Online, 19 Jan 2010 [Full text]
Limb Occlusion Pressure
Balaji Purushothaman
JBJS Online, 6 Jan 2010 [Full text]
Dr. Noordin and colleagues respond to Dr. Gavriely
Shahryar Noordin, MBBS, FCPS, et al.
JBJS Online, 19 Jan 2010 [Full text]
Dr. Noordin and colleagues respond to Mr. Purushothaman
Shahryar Noordin, MBBS, FCPS, et al.
JBJS Online, 6 Jan 2010 [Full text]
The Clinical Outcomes of Surgical Tourniquets in Orthopaedics?
Toby O. Smith, et al.
JBJS Online, 23 Feb 2010 [Full text]
Dr. Noordin and colleagues respond to Mr. Smith and Ms. Hing
Shahryar Noordin, MBBS, FCPS, et al.
JBJS Online, 23 Feb 2010 [Full text]