A Mobile Compression Device for Thrombosis Prevention in Hip and Knee Arthroplasty

Colwell, Clifford W.; Froimson, Mark I.; Anseth, S.; Giori, Nicholas J.; Hamilton, William G.; Barrack, Robert L.; Buehler, Knute C.; Mont, Michael A.; Padgett, Douglas E.; Pulido, Pamela A.; Barnes, C. Lowery

doi:10.2106/jbjs.l.01031

Cited by 67 publications

(72 citation statements)

References 29 publications

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“…Previous studies suggested that mechanical and pharmacological methods applied for VTE prophylaxis are both effective and, when used in combination, have synergistic effects. 25 Although there are a number of intermittent pneumatic compression systems, little evidence is available at present that differentiates these methods based on VTE prevention. It was demonstrated that calfÀthigh pneumatic compression was more effective than plantar compression for reducing thigh swelling during the early postoperative stage.…”

Section: Discussionmentioning

confidence: 99%

Effects of a foot pump on the incidence of deep vein thrombosis after total knee arthroplasty in patients given edoxaban

Motokawa¹

2016

http://isrctn.com/

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We conducted a randomized clinical trial to compare the effectiveness of the A-V Impulse System foot pump for reducing the incidence of deep-vein thrombosis (DVT) after total knee arthroplasty (TKA) in patients under edoxaban thromboprophylaxis.Patients undergoing primary TKA at our institution between September 2013 and March 2015 were enrolled after obtaining informed consent. The patients were randomized to use the foot pump (n ¼ 58) and not to use the foot pump (n ¼ 62). Both groups were given prophylactic edoxaban. Primary outcomes were any DVT as detected by bilateral ultrasonography up to postoperative day 10 (POD10) and pulmonary embolism (PE) up to POD28. The safety outcomes were bleeding and death of any cause up to POD28. Plasma D-dimer levels were measured before TKA and on POD10 after TKA. Immunoglobulin G (IgG)-class anti-PF4/heparin antibodies were measured using an IgGspecific enzyme-linked immunosorbent assay.The incidences of any DVT up to POD28 were 31.0% and 17.7% in patients with or without the foot pump, respectively. The incidences of major bleeding up to POD28 were 5.1% and 4.8% in patients with or without the foot pump, respectively. Foot pump use did not significantly reduce the incidence of DVTs in patients undergoing TKA under edoxaban thromboprophylaxis. Although seroconversion of anti-PF4/ heparin antibodies was confirmed in one-fourth of patients, the seroconversion rates did not differ between patients with (20.7%) or without (25.8%) foot pump use. This study shows that the A-V Impulse system foot pump did not affect the incidence of DVT under edoxaban thromboprophylaxis in patients undergoing TKA. Seroconversion of anti-PF4/heparin antibodies was detected in a significant number of patients who underwent TKA under antithrombotic prophylaxis using edoxaban.(Medicine 95(1):e2247)Abbreviations: CUS = compression US, DVT = deep vein thrombosis, HIT = heparin-induced thrombocytopenia, PE = pulmonary embolism, PF4 = platelet factor 4, POD = postoperative day, TKA = total knee arthroplasty.

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Section: Discussionmentioning

confidence: 99%

Effects of a foot pump on the incidence of deep vein thrombosis after total knee arthroplasty in patients given edoxaban

Motokawa¹

2016

http://isrctn.com/

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“…This synchronization significantly improves the venous return profile [47]. Two studies by Colwell et al [48,49] (n = 389 and 3060 patients), demonstrated no difference in efficacy versus chemoprophylactic agents. In a randomized clinical trial comparing the safety of mobile compression to LMWH, where 61% of the cohort received aspirin with the mobile device, they found that the device was associated with fewer bleeding events without compromising VTED efficacy [48].…”

Section: Mobile Vpf-regulated Compression Devicesmentioning

confidence: 93%

“…This study was powered for efficacy and not bleeding. In a multicenter level II prospective registry study evaluating data from 7 centers, the symptomatic VTE rates were assessed in patients using mobile compression both with (67%) and without aspirin (33%) following TKA (n = 1551) and THA (n = 1509) [49]. The symptomatic VTE-rate in patients treated with the mobile device (0.92%) was non-inferior (within 1%) to rates reported for pharmacologic prophylaxis in prior studies in the literature.…”

Section: Mobile Vpf-regulated Compression Devicesmentioning

confidence: 99%

A Current Review of Mechanical Compression and Its Role in Venous Thromboembolic Prophylaxis in Total Knee and Total Hip Arthroplasty

Pierce

Cherian

Jauregui

et al. 2015

The Journal of Arthroplasty

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“…This has led to accepting the method in VTE prophylaxis in a selected group of patients. The American College of Chest Physicians has recommended mechanical methods (foot or low leg pneumatic pump) alone primarily in patients at high risk of bleeding [26] and, because of their extra benefit, as an additional modality in prophylactic procedures in patients after orthopaedic surgery [27][28][29][30]. The same indications are found in the Polish guidelines [31].…”

Section: Venous Thromboembolism Prophylaxismentioning

confidence: 99%

Usefulness of intermittent pneumatic compression in medicine

Sutkowska¹

2017

Physiotherapy

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Many studies exist that document the use of intermittent pneumatic compression in lymphedema, venous ulcers, prophylaxis of deep vein thrombosis and limb ischaemia. This article discusses the basics and usefulness of this therapy on the basis of available studies and recommendations. As the method is characterized by lack of serious side effects, good patient compliance, and high effectiveness, intermittent pneumatic compression should be taken into consideration as an alternative or additional treatment in many conditions.

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A Mobile Compression Device for Thrombosis Prevention in Hip and Knee Arthroplasty

Abstract: Use of the mobile compression device with or without aspirin for patients undergoing arthroplasty of a lower-extremity joint provides a noninferior risk for the development of venous thromboembolism compared with current pharmacological protocols.

Cited by 67 publications

References 29 publications

Effects of a foot pump on the incidence of deep vein thrombosis after total knee arthroplasty in patients given edoxaban

Effects of a foot pump on the incidence of deep vein thrombosis after total knee arthroplasty in patients given edoxaban

A Current Review of Mechanical Compression and Its Role in Venous Thromboembolic Prophylaxis in Total Knee and Total Hip Arthroplasty

Usefulness of intermittent pneumatic compression in medicine

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