Is there not a better way to prevent venousthromboembolism after total knee arthroplasty?
Journal Title: Orthopaedics, Traumatology and Prosthetics - Year 2017, Vol 606, Issue 1
Abstract
Background: aspirin at 325 mg twice daily is now included as a nationally approved venous thromboembolism prophylaxis protocol for low risk total knee arthroplasty patients. The purpose of this study is to examine if there is a difference in deep vein thrombosis occurrence after a limited tourniquet total knee arthroplasty using aspirin-based prophylaxis with or without extended use of mechanical compression device therapy. Methods: one hundred limited tourniquet total knee arthroplasty patients, whose deep vein thrombosis risk was managed with aspirin 325 mg twice daily for 3 weeks, were randomized to either utilizing an mechanical compression device during hospitalization only or extended use at home up to six weeks post-op. Lower extremity Duplex venous ultrasonography was completed on the second post-op day, 14 days post-op, and at 3 months post-op to confirm absence of deep vein thrombosis after treatment. Results: the deep vein thrombosis rate for the post-discharge mechanical compression device therapy group was 0 % and 23.1 % for the inpatient mechanical compression device group (p < 0.001). All deep vein thrombosis resolved by 3 months postop. Patient satisfaction was 9.56 ± 0.82 for post-discharge mechanical compression device patients versus 8.50 ± 1.46 for in patient mechanical compression device patients (p < 0.001). Conclusion: limited tourniquet total knee arthroplasty patients that were mobilized early, managed with Aspirin for 3 weeks post-op, and mechanical compression device therapy for up to 6 weeks post-op experienced superior deep vein thrombosis prophylaxis than patients receiving mechanical compression device therapy only as an inpatient (p < 0.05). The 0 % incidence of non-symptomatic deep vein thrombosis prevented by Aspirin and extended use mechanical compression device further validates this type of prophylaxis in low deep vein thrombosis risk total knee arthroplasty patients.
Authors and Affiliations
Mark A. Snyder, Oleg Vyrva
Keywords
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- EP ID EP339722
- DOI 10.15674/0030-59872017172-79
- Views 168
- Downloads 0
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