Comparison of the effect of IPC on non operative side and bilateral sides in DVT prevention after hip and knee replacement

Abstract

Objective To investigate the effectiveness and safety of nonoperative side intermittent pneumatic compression (IPC) in hip and knee arthroplasty for the prevention of deep venous thrombosis. Methods From April 2017 to September 2017, patients who admitted to our hospital and scheduled for hip arthroplasty or knee arthroplasty were conducted prospectively according to the inclusion and exclusion criteria, 172 selected patients were randomly divided into experimental group and control group. All patients underwent non-operative side IPC at the time of surgery, and took postoperative rivaroxaban anticoagulation to prevent DVT. There were 85 patients in experimental group with persistent non-operative side IPC postoperatively; whereas there were 87 patients as control with persistent bilateral IPC postoperatively. Initially, IPC was given 1 h, twice a day for 3 days. Ultrasonic detection was conducted for DVT of both lower extremities on 2 time points, i.e. 3d and 7-10 d following surgery. Results Patient were hospitalized for 7-10 days after surgery, no patient fall off after operation. The follow-up time was 7-10 days, the average time was (8.3±1.3) d and the was 100%. In the experimental group, 11 patients had thrombosis at 3rd days after operation, accounting for 12.9%, all of which were intramuscular venous thrombosis. In the control group, 8 patients had thrombosis 3 days after operation, accounting for 9.2%, 1 case of iliac vein thrombosis and 2 cases of iliac vein thrombosis. The rest were intramuscular venous thrombosis. there was no significant difference in the DVT incidence of knee replacement, hip replacement and total DVT number between two groups. In the experimental group, 5 cases developed new thrombosis in the experimental group, accounting for 6.8%, and 4 cases developed new thrombosis in the control group, accounting for 5.1%. There was no statistically significant difference in the DVT incidence of the knee replacement patients, hip replacement patients and total DVT number 7-10 days after operation between two groups. Conclusion The non-surgical side of IPC can achieve the same preventive effect as the simultaneous use of IPC on both sides in the prevention of deep venous thrombosis after hip and knee replacement, and it is safer. Key words: Vein thrombosis; Intermittent pneumatic compression devices; Arthroplasty, replacement; Clinical trials