Clin Orthop Surg.  2017 Mar;9(1):37-42. 10.4055/cios.2017.9.1.37.

Intermittent Pneumatic Compression for the Prevention of Venous Thromboembolism after Total Hip Arthroplasty

• Kwak HS
• Cho JH
• Kim JT
• Yoo JJ
• Kim HJ

• KMID: 2412301
• DOI: http://doi.org/10.4055/cios.2017.9.1.37

Abstract

BACKGROUND
Venous thromboembolism (VTE) is a relatively common and potentially life threatening complication after major hip surgery. There are two main types of prophylaxis: chemical and mechanical. Chemical prophylaxis is very effective but causes bleeding complications in surgical wounds and remote organs. On the other hand, mechanical methods are free of hemorrhagic complications but are less effective. We hypothesized that mechanical prophylaxis is effective enough for Asians in whom VTE occurs less frequently. This study evaluated the effect of intermittent pneumatic compression (IPC) in the prevention of VTE after major hip surgery.
METHODS
Incidences of symptomatic VTE after primary total hip arthroplasty with and without application of IPC were compared. A total of 379 patients were included in the final analysis. The IPC group included 233 patients (106 men and 127 women) with a mean age of 54 years. The control group included 146 patients (80 men and 66 women) with a mean age of 53 years. All patients took low-dose aspirin for 6 weeks after surgery. IPC was applied to both legs just after surgery and maintained all day until discharge. When a symptom or a sign suspicious of VTE, such as swelling or redness of the foot and ankle, Homans' sign, and dyspnea was detected, computed tomography (CT) angiogram or duplex ultrasonogram was performed.
RESULTS
Until 3 months after surgery, symptomatic VTE occurred in three patients in the IPC group and in 6 patients in the control group. The incidence of VTE was much lower in the IPC group (1.3%) than in the control group (4.1%), but the difference was not statistically significant. Complications associated with the application of IPC were not detected in any patient. Patients affected by VTE were older and hospitalized longer than the unaffected patients.
CONCLUSIONS
The results of this study suggest that IPC might be an effective and safe method for the prevention of postoperative VTE.

Keyword

Venous thromboembolism; Prevention; Pneumatic compression

MeSH Terms

Adult
Age Factors
Aged
Arthroplasty, Replacement, Hip/*adverse effects
Asian Continental Ancestry Group
Aspirin/administration & dosage
Computed Tomography Angiography
Female
Humans
*Intermittent Pneumatic Compression Devices
Leg
Length of Stay
Male
Middle Aged
Platelet Aggregation Inhibitors/administration & dosage
Postoperative Complications/diagnostic imaging/etiology/*prevention & control
Pulmonary Embolism/diagnostic imaging/prevention & control
Republic of Korea
Risk Factors
Ultrasonography, Doppler, Duplex
Venous Thromboembolism/diagnostic imaging/etiology/*prevention & control
Venous Thrombosis/diagnostic imaging/prevention & control
Platelet Aggregation Inhibitors
Aspirin

Figure

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  Fig. 1 Main body with accessories (A) and cuff (B) of the intermittent pneumatic pump used in this study.

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