Efficacy in Deep Vein Thrombosis Prevention With Extended Mechanical Compression Device Therapy and Prophylactic Aspirin Following Total Knee Arthroplasty: A Randomized Control Trial.
Aspirin at 325 mg twice daily is now included as a nationally approved venous thromboembolism (VTE) prophylaxis protocol for low-risk total knee arthroplasty (TKA) patients. The purpose of this study is to examine whether there is a difference in deep vein thrombosis (DVT) occurrence after a limited tourniquet TKA using aspirin-based prophylaxis with or without extended use of mechanical compression device (MCD) therapy.



One hundred limited tourniquet TKA patients, whose DVT risk was managed with aspirin 325 mg twice daily for 3 weeks, were randomized to either using an MCD during hospitalization only or extended use at home up to 6 weeks postoperatively. Lower extremity duplex venous ultrasonography (LEDVU) was completed on the second postoperative day, 14 days postoperatively, and at 3 months postoperatively to confirm the absence of DVT after treatment.



The DVT rate for the postdischarge MCD therapy group was 0% and 23.1% for the inpatient MCD group (P < .001). All DVTs resolved by 3 months postoperatively. Patient satisfaction was 9.56 (±0.82) for postdischarge MCD patients vs 8.50 (±1.46) for inpatient MCD patients (P < .001).



Limited tourniquet TKA patients who were mobilized early, managed with aspirin for 3 weeks postoperatively, and on MCD therapy for up to 6 weeks postoperatively experienced superior DVT prophylaxis than patients receiving MCD therapy only as an inpatient (P < .05). The 0% incidence of nonsymptomatic DVTs prevented by aspirin and extended-use MCD further validates this type of prophylaxis in low DVT risk TKA patients.
Trihealth Orthopaedic and Sports Institute, Cincinnati, Ohio.
Mark A
MA
Snyder
Trihealth Hatton Research Institute, Good Samaritan Hospital, Cincinnati, Ohio.
Alexandra N
AN
Sympson
Trihealth Hatton Research Institute, Good Samaritan Hospital, Cincinnati, Ohio.
Christina M
CM
Scheuerman
Trihealth Hatton Research Institute, Good Samaritan Hospital, Cincinnati, Ohio.
Justin L
JL
Gregg
Trihealth Hatton Research Institute, Good Samaritan Hospital, Cincinnati, Ohio.
Lala R
LR
Hussain
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods*; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000209:etiology / Q000517:prevention & control*; D014945:Wound Healing
D001241:Aspirin
aspirin; deep vein thrombosis; mechanical compression; mobilization; prophylaxis; total knee