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Prophylaxis Against Venous Thromboembolic Disease in Patients Having a Total Hip or Knee Arthroplasty

Source:
Sculco TP, Colwell CW, Pellegrini Jr. VD, et al: J Bone Joint Surg 84–A(3): 466–477, 2002

Summary:
This Instructional Course Lecture conducted at the American Academy of Orthopaedic Surgeons meeting explored mechanical and chemical prophylaxis for patients undergoing total joint replacement. Rates and locations of DVT and caveats associated with specific procedures are described. The advantages of rapid, multi-chamber, asymmetric calf compression over thigh and foot compression is discussed in-depth.

The ideal device is described. “On the basis of in vivo flow studies, it appears that a calf compression device (with or without sequential foot compression) with and asymmetric multichamber system that applies at least 50 mmHg of sequential external pressure at a frequency of at least once per minute with an inflation time of less than one second is the ideal device for prophylaxis against deep venous thrombosis in patients undergoing elective orthopaedic surgery.”

The role and safety measures required for intraoperative use of IPC are also discussed by the panel in this in-depth paper and lecture.