Pneumatic compression device does not show effective thromboprophylaxis following total knee arthroplasty in a low incidence population
| Autor: | Dae-Kyung Bae, Sang Jun Song, Se-Jung Hong, Dong-Kyoon Kim, Kang-Il Kim |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Deep vein medicine.medical_treatment Population Venography Intermittent pneumatic compression 03 medical and health sciences 0302 clinical medicine Postoperative Complications Osteoarthritis Medicine Humans Orthopedics and Sports Medicine cardiovascular diseases Postoperative Period education Arthroplasty Replacement Knee Intermittent Pneumatic Compression Devices Aged Ultrasonography Venous Thrombosis 030222 orthopedics education.field_of_study medicine.diagnostic_test business.industry Incidence (epidemiology) Anticoagulants 030229 sport sciences Phlebography Middle Aged medicine.disease Arthroplasty Surgery Pulmonary embolism medicine.anatomical_structure Case-Control Studies Chemoprophylaxis Female business |
| Zdroj: | Orthopaedicstraumatology, surgeryresearch : OTSR. 105(1) |
| ISSN: | 1877-0568 |
| Popis: | Introduction Purpose of this study was to assess whether the intermittent pneumatic compression (IPC) device would be an effective prophylaxis for deep vein thrombosis (DVT) following total knee arthroplasty (TKA) in a low incidence population. Hypothesis The mechanical thromboprophylaxis could reduce the incidence of DVT compared to non-prophylaxis group and would have similar efficacy as the chemoprophylaxis following TKA in a low DVT incidence population. Materials and methods From January 2009 to June 2016, 1259 elective primary TKA with preoperative diagnosis of primary osteoarthritis in a single institute were enrolled. Patients were divided into three groups: those who were managed with chemoprophylaxis (CPX group, 414 cases), with mechanical prophylaxis (IPC group, 425 cases), or without pharmacological and mechanical prophylaxis (control group, 420 cases). All patients underwent preoperative ultrasonography and computed tomographic venography on postoperative day 6 to assess development of DVT. The incidence of overall, proximal, symptomatic DVT and symptomatic pulmonary embolism (PE) were compared among the groups. Major and minor bleeding complications were also evaluated. Results The incidence of overall DVT was 14.8% in control group, 6.3% in CPX group and 11.3% in IPC group respectively and CPX group showed significantly lower incidence than other two groups (p 0.05). The incidence of symptomatic DVT was 0.7% in control group, 0% in CPX group and 0.7% in IPC group respectively (p > 0.05). There was no case of symptomatic PE diagnosed during hospital stay in all patients. Discussion Single use of IPC device could not reach significant level of DVT prophylaxis compared to control group and only chemoprophylaxis showed significantly reduce the incidence of overall DVT following TKA. Single use of IPC device does not show effective thromboprophylaxis in a low DVT incidence population. Level of evidence III, case control study. |
| Databáze: | OpenAIRE |
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