Pneumatic compression device does not show effective thromboprophylaxis following total knee arthroplasty in a low incidence population - 28/01/19
, Sang-Jun Song b, Se-Jung Hong a, Dae-Kyung Bae b
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Abstract |
Introduction |
Purpose of this study was to assess whether the intermittent pneumatic compression (IPC) device would be an effective prophylaxis for deep vein thrombosis (DVT) following total knee arthroplasty (TKA) in a low incidence population.
Hypothesis |
The mechanical thromboprophylaxis could reduce the incidence of DVT compared to non-prophylaxis group and would have similar efficacy as the chemoprophylaxis following TKA in a low DVT incidence population.
Materials and methods |
From January 2009 to June 2016, 1259 elective primary TKA with preoperative diagnosis of primary osteoarthritis in a single institute were enrolled. Patients were divided into three groups: those who were managed with chemoprophylaxis (CPX group, 414 cases), with mechanical prophylaxis (IPC group, 425 cases), or without pharmacological and mechanical prophylaxis (control group, 420 cases). All patients underwent preoperative ultrasonography and computed tomographic venography on postoperative day 6 to assess development of DVT. The incidence of overall, proximal, symptomatic DVT and symptomatic pulmonary embolism (PE) were compared among the groups. Major and minor bleeding complications were also evaluated.
Results |
The incidence of overall DVT was 14.8% in control group, 6.3% in CPX group and 11.3% in IPC group respectively and CPX group showed significantly lower incidence than other two groups (p<0.001). The incidence of proximal DVT was 1.9% in control group, 0.7% in CPX group and 0.9% in IPC group respectively (p>0.05). The incidence of symptomatic DVT was 0.7% in control group, 0% in CPX group and 0.7% in IPC group respectively (p>0.05). There was no case of symptomatic PE diagnosed during hospital stay in all patients.
Discussion |
Single use of IPC device could not reach significant level of DVT prophylaxis compared to control group and only chemoprophylaxis showed significantly reduce the incidence of overall DVT following TKA. Single use of IPC device does not show effective thromboprophylaxis in a low DVT incidence population.
Level of evidence |
III, case control study.
Le texte complet de cet article est disponible en PDF.Keywords : Total knee arthroplasty, Deep vein thrombosis, Pneumatic compression, Chemoprophylaxis, Thromboprophylaxis
Plan
Vol 105 - N° 1
P. 71-75 - février 2019 Retour au numéro
Article précédent
- Kinematic alignment technique for medial OXFORD UKA: An in-silico study
- Charles Rivière, Ciara Harman, Anthony Leong, Justin Cobb, Cedric Maillot
- Predictive factors for satisfaction after contemporary unicompartmental knee arthroplasty and high tibial osteotomy in isolated medial femorotibial osteoarthritis
- In Jun Koh, Man Soo Kim, Sueen Sohn, Kwang Yun Song, Nam Yong Choi, Hoyoung Jung, Yong In
Bienvenue sur EM-consulte, la référence des professionnels de santé.