Different types of intermittent pneumatic compression devices for preventing venous thromboembolism in patients after total hip replacement

Department of Orthopaedics Trauma and Hand Surgery, 1st Affiliated Hospital of Guangxi Medical University, No. 22, Shuang Yong Road, Nanning, China, 530021.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 11/2012; 11(11):CD009543. DOI: 10.1002/14651858.CD009543.pub2
Source: PubMed


Total hip replacement (THR) is an orthopedic procedure which has been performed for decades now to reduce pain and improve function and quality of life in people with severe hip disorders. It shows excellent results in terms of both improved function and value for money. While this operation is very successful, patients are at high risk of developing venous thromboembolic disease such as deep vein thrombosis (DVT) and pulmonary embolism (PE) in the immediate postoperative period. Intermittent pneumatic compression (IPC) devices are used to decrease the risk of such events. There are several different types of IPC device with variations in their design, including the rate and means of compression. We looked for randomized controlled trials which compared different types of IPC devices for preventing venous thromboembolism in patients after THR. We found one study with 121 participants comparing a calf-thigh compression device with a foot (plantar) compression device. There were no cases of symptomatic DVT or PE either in the calf-thigh compression group or the plantar compression group in the first three weeks after the THR. The calf-thigh pneumatic compression was more effective than plantar compression for reducing thigh swelling one week following surgery. The postoperative swelling in the calf-thigh pump group was reduced earlier than in the plantar pump group. However, other outcomes such as imaging-diagnosed asymptomatic VTE were not determined and it is not possible to draw reliable conclusions from this single study with a high risk of bias. We therefore suggest that more primary research is required to allow an informed choice of IPC device for preventing venous thromboembolism following THR.

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