Summary
The use of tournique for arthroscopic meniscectomy increases anterior knee pain
Abstract
Introduction
Tourniquet use in knee arthroscopy has been related to a greater loss of muscle mass, especially in the vastus medialis. On the other hand, different studies relate vastus medialis hypotrophy as a possible etiology of anterior knee pain. Therefore, it is worth considering that tourniquet could cause a greater incidence of patellofemoral pain.
Objective
The objective of this work is to evaluate if tourniquet use causes more patellofemoral pain in comparison with its non-use in knee arthroscopic meniscectomy.
Methods
Prospective randomized study, comparing use (group-1) versus non-use (group-2) of tourniquet in knee arthroscopic meniscectomy. Patients aged 18 to 55 years undergoing partial meniscectomy were included, from July-2020 to May-2023.
Variables collected included subjective patellofemoral pain, measured using the Kujala score; anterior pain measured in kPa, using pressure algomether; global pain, assessed with VAS scale; vastus medialis volume (mm2) measured by MRI. All variables were assessed preoperatively and at the 6th postoperative week.
Results
72 patients were included, 52 men and 20 women, with an average age of 44.5 years (SD6.8). 37 patients were included in group-1 and 35 in group-2, being the groups comparable tin terms of age, sex, laterality and BMI.
The groups were also comparable preoperatively in terms of subjective patellofemoral pain (62.4 vs 64.4, p=0.74), anterior knee pain (585.8 vs 639.1, p=0.35), global pain (5 vs 4.9, p=0.91) and vastus medial volume (1569.1 vs 1410.8mm2, p=0.90).
In the postoperative period, patients in group-1 had greater subjective patellofemoral pain (84.9 vs 90.2, p=0.03) and greater anterior knee pain (490.4 vs 621.6, p<0.01). No differences were found in terms of global pain (1.7 vs 1.9, p=0.49) or vastus medialis volume (1421.5 vs 1292.25, p=0.52).
Conclusion
Tourniquet use in arthroscopic knee meniscectomy is associated with greater anterior knee pain. However, it has not been possible to relate vastus medialis hipotrophy as an etiological factor.