title: Effect of pneumatic compression on fibrinolysis after total hip arthroplasty.
abstract: The purpose of this prospective randomized clinical study was to investigate the enhanced systemic fibrinolysis mechanism of venous thrombosis prevention by pneumatic compression after total hip arthroplasty. Fifty patients were randomized into one of two groups (one with pneumatic compression [n=25] and one without [n=25]). Blood was drawn from a radial arterial line immediately preoperatively (baseline), at skin closure, and 8 hours and 22 hours after the baseline sample. Serum determinations of antigen of tissue plasminogen activator and plasminogen activator inhibitor-1 were done using enzyme-linked immunosorbent assays. These data do not support the enhancement of systemic fibrinolysis mechanism for lowering thromboembolic risk after total hip arthroplasty by pneumatic compression devices. The results of this study showed no differences that were statistically significant between the two groups. The greatest difference was observed 8 hours after surgery for the plasminogen activator inhibitor-1 marker, (28.12 with compression versus 22.07 ng/mL without); however, this result was not statistically significant. The beneficial effect of mechanical compression is more likely achieved through increased flow, local fibrinolytic effects, or both.
authors.affiliation: Center for Hip and Knee Replacement, Columbia University, PH 11th Floor, Rm 1146, 622 West 168th Street, New York, NY 10032, USA.
authors.forename: William
authors.initials: W
authors.lastname: Macaulay
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Westrich
authors.forename: Nigel
authors.initials: N
authors.lastname: Sharrock
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Sculco
authors.forename: Peter H
authors.initials: PH
authors.lastname: Jhon
authors.forename: Margaret G E
authors.initials: MG
authors.lastname: Peterson
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: Salvati
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D001458:Bandages; D005260:Female; D005342:Fibrinolysis / Q000502:physiology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D011312:Pressure; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D010959:Tissue Plasminogen Activator / Q000097:blood; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000517:prevention & control*
chemical_list: D017395:Plasminogen Activator Inhibitor 1; D010959:Tissue Plasminogen Activator