title: Mobile pump deep vein thrombosis prophylaxis: just say no to drugs.
abstract: OBJECTIVE
  The purpose of this article was to review the current literature pertaining to the use of mobile compression devices (MCDs) for venous thromboembolism (VTE) following total joint arthroplasty (TJA), and to discuss the results of data from our institution.
  
  
  METHODS
  Previous studies have illustrated higher rates of post-operative wound complications, re-operation and re-admission with the use of more aggressive anticoagulation regimens, such as warfarin and factor Xa inhibitors. This highlights the importance of the safety, as well as efficacy, of the chemoprophylactic regimen.
  
  
  RESULTS
  Studies have shown a symptomatic VTE rate of 0.92% with use of MCDs for prophylaxis, which is comparable with rates seen with more aggressive anticoagulation protocols. A prior prospective study found that use of a pre-operative risk stratification protocol based on personal history of deep vein thrombosis, family history of VTE, active cancer, or a hypercoaguable state allowed for the avoidance of aggressive prophylactic anticoagulation in over 70% of patients while maintaining a low incidence of symptomatic VTE.
  
  
  CONCLUSIONS
  Further investigation is needed into the role of aspirin in VTE prophylaxis as well as the efficacy of MCDs as stand-alone prophylactic treatment. Cite this article: Bone Joint J 2017;99-B(1 Supple A):8-13.
authors.affiliation: Washington University Orthopedics, Barnes Jewish Hospital, 660 S. Euclid Avenue, Campus Box 8233, St. Louis, MO, 63110, USA.
authors.forename: J
authors.initials: J
authors.lastname: Haynes
authors.affiliation: Washington University Orthopedics, Barnes Jewish Hospital, 660 S. Euclid Avenue, Campus Box 8233, St. Louis, MO, 63110, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Barrack
authors.affiliation: Washington University Orthopedics, Barnes Jewish Hospital, 660 S. Euclid Avenue, Campus Box 8233, St. Louis, MO, 63110, USA.
authors.forename: D
authors.initials: D
authors.lastname: Nam
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000379:methods; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D019643:Arthroplasty, Replacement / Q000009:adverse effects*; D001241:Aspirin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D019106:Postoperative Hemorrhage / Q000209:etiology; D018570:Risk Assessment / Q000379:methods; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000209:etiology / Q000517:prevention & control*; D014859:Warfarin / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D001241:Aspirin
keywords: Anticoagulation; Deep vein thrombosis; Mobile compression devices; Pulmonary embolus; Venous thromboembolism