Thrombo-embolic prophylaxis in total knee replacement. Evaluation of the A-V Impulse System.
We performed a prospective randomised controlled trial of a new mechanical method of prophylaxis for venous thrombo-embolism in 60 patients undergoing knee replacement surgery. The method uses the A-V Impulse System to produce cyclical compression of the venous reservoir of the foot. The overall incidence of deep-vein thrombosis was 68.7% in patients receiving no prophylaxis and 50% in those using the device. The difference was not significant. There was, however, a reduction of the extent of thrombosis in the treated group. There were 13 major calf-vein thrombi and six proximal-vein thrombi in the control group compared with only five major calf-vein thrombi in the treated group. This difference was significant (p = 0.014). No patient developed clinical features of a pulmonary embolism.
Wilson
N V
NV
Department of Orthopaedic Surgery, King's College Hospital, London, England.
Das
S K
SK
Kakkar
V V
VV
Maurice
H D
HD
Smibert
J G
JG
Thomas
E M
EM
Nixon
J E
JE
D000368:Aged; D000369:Aged, 80 and over; D001243:Assisted Circulation / Q000295:instrumentation*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D015994:Incidence; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D011859:Radiography; D013923:Thromboembolism / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control*; D013924:Thrombophlebitis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control