title: Different types of intermittent pneumatic compression devices for preventing venous thromboembolism in patients after total hip replacement.
abstract: BACKGROUND
  Total hip replacement (THR) is an effective treatment for reducing pain and improving function and quality of life in patients with hip disorders. While this operation is very successful, deep vein thrombosis (DVT) and pulmonary embolism (PE) are significant complications after THR. Different types of intermittent pneumatic compression (IPC) devices have been used for thrombosis prophylaxis in patients following THR. Available devices differ in compression garments, location of air bladders, patterns of pump pressure cycles, compression profiles, cycle length, duration of inflation time and deflation time, or cycling mode such as automatic or constant cycling devices. Despite the widely accepted use of IPC for the treatment of arterial and venous diseases, the relative effectiveness of different types of IPC systems as prophylaxis against thrombosis after THR is still unclear.
  
  
  OBJECTIVE
  To assess the comparative effectiveness and safety of different IPC devices with respect to the prevention of venous thromboembolism in patients after THR.
  
  
  METHODS
  For this update the Cochrane Peripheral Vascular Diseases Group Trials Search Coordinator searched the Specialised Register (November 2014), CENTRAL (2014, Issue 10). Clinical trial databases were searched for details of ongoing and unpublished studies. Reference lists of relevant articles were also screened. There were no limits imposed on language or publication status.
  
  
  METHODS
  Randomized and quasi-randomized controlled studies were eligible for inclusion.
  
  
  METHODS
  Two review authors independently selected trials, assessed trials for eligibility and methodological quality, and extracted data. Disagreement was resolved by discussion or, if necessary, referred to a third review author.
  
  
  RESULTS
  Only one quasi-randomized controlled study with 121 study participants comparing two types of IPC devices met the inclusion criteria. The authors found no cases of symptomatic DVT or PE in either the calf-thigh compression group or the plantar compression group during the first three weeks after the THR. The calf-thigh pneumatic compression was more effective than plantar compression for reducing thigh swelling during the early postoperative stage. The strength of the evidence in this review is weak as only one trial was included and it was classified as having a high risk of bias.
  
  
  CONCLUSIONS
  There is a lack of evidence from randomized controlled trials to make an informed choice of IPC device for preventing venous thromboembolism (VTE) following total hip replacement. More research is urgently required, ideally a multicenter, properly designed RCT including a sufficient number of participants. Clinically relevant outcomes such as mortality, imaging-diagnosed asymptomatic VTE and major complications must be considered.
authors.affiliation: Department of Orthopaedics Trauma and Hand Surgery, 1st Affiliated Hospital of Guangxi Medical University,  Nanning, China.
authors.forename: Jin Min
authors.initials: JM
authors.lastname: Zhao
authors.forename: Mao Lin
authors.initials: ML
authors.lastname: He
authors.forename: Zeng Ming
authors.initials: ZM
authors.lastname: Xiao
authors.forename: Ting Song
authors.initials: TS
authors.lastname: Li
authors.forename: Hao
authors.initials: H
authors.lastname: Wu
authors.forename: Hua
authors.initials: H
authors.lastname: Jiang
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D011183:Postoperative Complications / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D054556:Venous Thromboembolism / Q000517:prevention & control*