Foot pumps without graduated compression stockings for prevention of deep-vein thrombosis in total joint replacement: efficacy, safety and patient compliance

Abstract

Mechanical prophylaxis with foot pumps provides an interesting alternative to chemical agents in the prevention of thromboembolic disease following major orthopaedic surgical procedures. Recent studies have suggested that the simultaneous use of graduated compression stockings (GCS) may hinder the pneumatic compression effect of foot pumps.

Thromboprophylaxis in Radical Retropubic Prostatectomy: Efficacy and Patient Compliance of a Dual Modality

“…As reported by others, we found that 4/6 subjects among those requiring the early discontinuation of the compression attributed it to the noise. This is consistent with the few data from the literature showing that sleep disturbances attributed to noise was the more frequent reason (69-81%) for premature termination [16][17][18][19][20][21][22][23][24][25][26] .…”

Flowtron foot-pumps for prevention of venous thromboembolism in total hip and knee replacement

“…3 A-V Impulse foot pumps are effective and safe in THR. 11,13,15 After TKR, the effectiveness of foot-pumps is less certain, with some studies reporting a benefit, whereas other did not. 4,17,18 To our knowledge, this is the first prospective trial performed to establish efficacy and safety of the Flowtron ® foot pump system, a widely used device, but apparently not sufficiently validated in clinical settings.…”

“…In some patients, the surgeon advised use of foot-pumps without simultaneous application of antithrombotic stockings. 11,16 Various chemicals were prescribed in combination with the foot-pumps. However, in some young and healthy patients the surgeon elected to use only foot pumps for prevention of venous thromboembolism.…”

“…The AV-impulse foot compression system has shown a proven benefit in preventing thromboembolic events. 6,10,11,13,15 Following a tendering process by the local District Health board, a new device, the Flowtron Universal compression system was introduced (Flowtron ® , ArjoHuntleigh, Luton, UK). This system, even if quite similar to the original AV-Impulse, lacks of published data for clinical validation.…”

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

“…Despite positive results, compliance remains a barrier to effective foot pump use due to complaints of disturbed sleep and decreased mobility [60][61][62]. Charalambous et al [60] assessed compliance in 29 patients after TKA or THA, and found that they were worn, applied properly, and functioning correctly only in 37% of observations (n = 231 of 621).…”