Abstract
Venous thromboembolism (VTE) is a severe complication in orthopedic surgeries. Herein, we developed a novel leg exercise apparatus (LEX) to encourage postoperative limb movement in bedridden patients to prevent VTE. We aimed to evaluate its feasibility and safety in individuals at risk of VTE. Twenty patients (four men, 16 women) who underwent total joint arthroplasty in the lower extremity were enrolled in this prospective study. Exercise using the LEX was performed for 5 min at 30 cycles/min, four times/day during postoperative days 1–7. Clinical assessments included the evaluation of vital signs, venous ultrasonography, and blood tests within seven days postoperatively, and adverse events (pulmonary embolism and cerebral hemorrhage) were monitored. Overall, 16/20 (80%) patients completed the 7-day exercise regimen. There were no cases of severe adverse events, changes in vital signs, or lower-extremity deep vein thrombosis in patients who performed exercises with the LEX. Thus, the results of this pilot study show that this novel apparatus may be a safe and feasible tool for VTE prophylaxis after joint arthroplasty of the lower extremities.
Highlights
Venous thromboembolism (VTE) is a medical condition that includes deep vein thrombosis (DVT) and pulmonary embolism (PE) [1,2]
We propose to evaluate the efficacy of the leg exercise apparatus (LEX) in combination with established strategies to prevent VTE development in bedridden patients
The use of the LEX after total joint arthroplasty of the lower extremities was associated with very good acceptance and no severe adverse events
Summary
Venous thromboembolism (VTE) is a medical condition that includes deep vein thrombosis (DVT) and pulmonary embolism (PE) [1,2]. Orthopedic surgery of the lower limbs constitutes a high-risk factor for VTE development: patients undergoing total hip and knee arthroplasty show an incidence of this complication of approximately 0.6–1.5% [3,4]. DVT of the lower limbs usually develops in the calf veins, especially those in the soleus muscle, and is a frequent source of pulmonary emboli [5,6,7]. Academy of Orthopedic Surgeons (AAOS) [9] recommend mechanical and pharmacological thromboprophylaxis in patients undergoing orthopedic surgery. Mechanical prophylaxis aims to avoid blood flow stasis, which is considered the main risk factor for DVT in “Virchow’s triad” [10,11]
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