title: Graded compression stockings in elective orthopaedic surgery. An assessment of the in vivo performance of commercially available stockings in patients having hip and knee arthroplasty.
abstract: We recruited 89 patients who had hip or knee replacements to assess the performance of below-knee graded compression stockings. The pressure gradients generated by the stockings were measured and all patients had venography of the ipsilateral leg. We found that 98% of stockings failed to produce the 'ideal' pressure gradient (+/- 20%) of 18, 14 and 8 mmHg from the ankle to the knee, while 54% produced a 'reversed gradient' on at least one occasion during the course of the study. The overall rate of deep-venous thrombosis was 16.7%. Stockings which produced reversed gradients were associated with a significantly higher incidence of deep-venous thrombosis (p = 0.026) than those with the correct gradient (25.6% v 6.1%). This suggests that the performance of graded compression stockings can be improved if reversed pressure gradients are detected and prevented.
authors.affiliation: Department of Orthopaedic Surgery, Glenfield Hospital, Leicester, England, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Best
authors.forename: S
authors.initials: S
authors.lastname: Williams
authors.forename: A
authors.initials: A
authors.lastname: Crozier
authors.forename: R
authors.initials: R
authors.lastname: Bhatt
authors.forename: P J
authors.initials: PJ
authors.lastname: Gregg
authors.forename: A C
authors.initials: AC
authors.lastname: Hui
mesh_terms: D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D001458:Bandages; D006801:Humans; D011312:Pressure; D020246:Venous Thrombosis / Q000453:epidemiology / Q000517:prevention & control