Continuous passive motion for preventing venous thromboembolism after total knee arthroplasty

He, Mao Lin; Xiao, Zeng; Lei, Ming; Li, Ting Song; Wu, Hao; Liao, Jun

doi:10.1002/14651858.cd008207.pub3

Cited by 25 publications

(16 citation statements)

References 34 publications

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“… 27 Meta-analysis concluded that leg compression augments the efficacy of pharmacological prophylaxis in preventing DVT in both TKA and THA. 28 Whereas other studies could not demonstrate the effectiveness of mechanical prophylaxis in preventing DVT compared to the pharmacological prophylaxis. 29 , 30 Although evidence from nonorthopedic patient populations suggests an advantage for combined mechanical and pharmacological prophylaxis, there are insufficient data to conclude whether combined modalities are better than either anticoagulants or mechanical compression used alone.…”

Section: Discussionmentioning

confidence: 98%

Effects of a Foot Pump on the Incidence of Deep Vein Thrombosis After Total Knee Arthroplasty in Patients Given Edoxaban

et al. 2016

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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 = 58) and not to use the foot pump (n = 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 IgG-specific 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.

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Section: Discussionmentioning

confidence: 98%

Effects of a Foot Pump on the Incidence of Deep Vein Thrombosis After Total Knee Arthroplasty in Patients Given Edoxaban

et al. 2016

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“…27 Meta-analysis concluded that leg compression augments the efficacy of pharmacological prophylaxis in preventing DVT in both TKA and THA. 28 Whereas other studies could not demonstrate the effectiveness of mechanical prophylaxis in preventing DVT compared to the pharmacological prophylaxis. 29,30 Although evidence from nonorthopedic patient populations suggests an advantage for combined mechanical and pharmacological prophylaxis, there are insufficient data to conclude whether combined modalities are better than either anticoagulants or mechanical compression used alone.…”

Section: Discussionmentioning

confidence: 98%

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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“…Older reviews seem to favor the use of CPM, 59.60 while more recent reviews seem to show no benefit. 61,62 Conflicting conclusions of the systematic reviews were a result of different inclusion and exclusion criteria. Reviews that included studies in which post-TKA patients who received CPM were compared with patients whose knees were immobilized found a benefit with CPM.…”

Section: Short-term Postoperative Interventionsmentioning

confidence: 99%

Perioperative Physiotherapy in Total Knee Arthroplasty

Joice¹,

Bhowmick²,

Amanatullah³

2017

Orthopedics

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Total knee arthroplasty has a high success rate. In the interest of enhancing patient outcomes, numerous perioperative interventions have been studied, including preoperative education, preoperative rehabilitation, postoperative inpatient rehabilitation, continuous passive motion, postoperative outpatient rehabilitation, unsupervised in-home exercises, telerehabilitation, and various combinations of these. This comprehensive review analyzes the existing body of evidence on these perioperative interventions and examines some burgeoning opportunities in rehabilitation after total knee arthroplasty in the interest of improving patient outcomes and ensuring sustainable health care utilization for the future of total knee arthroplasty. [Orthopedics. 2017; 40(5):e765-e773.].

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Continuous passive motion for preventing venous thromboembolism after total knee arthroplasty

Cited by 25 publications

References 34 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

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

Perioperative Physiotherapy in Total Knee Arthroplasty

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