Thromboembolism after total knee arthroplasty: intermittent pneumatic compression and aspirin prophylaxis.
This is a study of two consecutive antithromboembolism regimens after total knee arthroplasty. In group 1, 131 patients were given aspirin prophylaxis alone (650 mg by mouth twice a day). In group 2, 123 patients were treated with aspirin, knee-high compression stockings, and intermittent knee-high pneumatic compression devices, which were started intraoperatively. The prevalence of deep vein thrombosis in group 1 was 15.9% (21 of 131 patients). One patient had a possible symptomatic nonfatal pulmonary embolism, and one patient had a symptomatic calf thrombus. Asymptomatic thrombi were detected in calf veins in 9 patients, popliteal vein in 6 patients, and femoral vein in 5 patients. In Group 2, the prevalence was 7.4% (9 of 123 patients). Asymptomatic thrombi were located in calf veins in 6 patients, popliteal vein in 1 patient, and femoral vein in 2 patients. There was a significant difference in the prevalence of deep vein thrombosis between the two groups. A history of previous thromboembolism was a significant risk factor for a new thrombus. The prevalence after bilateral one-stage knee arthroplasty was 24.3% for group 1 and 12.5% for group 2. Aspirin and knee-high intermittent pneumatic compression together are more effective than aspirin alone for prevention of deep vein thrombosis after primary and revision knee arthroplasty.
Department of Orthopaedic Surgery, University of North Carolina School of Medicine, Chapel Hill 27599-7055, USA.
C M
CM
Larson
D P
DP
MacMillan
P F
PF
Lachiewicz
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D019645:Arthroplasty, Replacement, Knee; D001241:Aspirin / Q000627:therapeutic use*; D001458:Bandages; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011312:Pressure; D011446:Prospective Studies; D013923:Thromboembolism / Q000209:etiology*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin