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Mobile compression device prevented risk of DVT after joint surgery
Compared with current pharmacological protocols, use of the mobile compression device with or without aspirin provides a noninferior risk for the development of venous thromboembolism among patients undergoing arthroplasty of a lower-extremity joint, according to study results published in the Journal of Bone and Joint Surgery.
To capture the rate of symptomatic venous thromboembolic events following primary knee arthroplasty or hip arthroplasty from 10 sites, researchers developed a multicenter registry. Patients 18 years of age or older with no known history of venous thromboembolism, coagulation disorder or solid tumor used the compression device perioperatively and continued for a minimum of 10 days. Patients with symptoms of deep venous thrombosis or pulmonary embolism underwent duplex ultrasonography or spiral computed tomography. Researchers evaluated all patients at 3 months postoperatively to document any evidence of deep venous thrombosis or pulmonary embolism.
Twenty-eight patients had venous thromboembolism and one death occurred. According to study results, patients who experienced arthroplasty of a lower-extremity joint using the mobile compression device had symptomatic venous thromboembolic rates similar to rates reported for pharmacological prophylaxis, including warfarin, enoxaparin, rivaroxaban and dabigatran, at a margin of 1%. However, the mobile compression device fell short of the rate reported for rivaroxaban by 0.06% in knee arthroplasty group.
“Blood thinners have long been considered the standard of care to prevent blood clots after orthopedic surgery, but they can have side effects that are concerning for many patients,” Clifford Colwell, MD, of The Shiley Center for Orthopaedic Research and Education at Scripps Clinic, stated. “Through this research we have found and established an equally effective means of accomplishing the same goal with an added layer of safety for patients.”
Resources:
Colwell CW. J Bone Joint Surg. 2014;doi:10.2106/JBJS.L.01031.
Disclosure: Clifford Colwell provided expert testimony on various legal cases. Douglas Padgett is a consultant for Mako and Stryker and received patents, royalties and stock options from Mako. Michael Mont is a consultant for Stryker Orthopaedics, Wright Medical Technology Inc, Tissue Gene, Janssen, Salient Surgical and Sage Products Inc. Mont also received payment for manuscript preparation from Stryker Orthopaedics and Wright Medical Technology Inc and royalties from Stryker Orthopaedics. William Hamilton is a consultant for DePuy, received payment for lectures from DePuy, Salient/ Medtronic and Biomet and travel expenses from DePuy. Mark Froimson is a consultant for and receives stock options from Medical Compression Systems and received royalties and travel accommodations from DePuy Orthopaedics. Knute Buehler is a consultant for MSC Corp. Robert Barrack is a board member at the American Association of Hip and Knee Surgeons, the Hip Society, the Knee Society and the Current Concepts Foundation and a consultant for Stryker. Buehler also received royalties from Smith & Nephew. C. Lowery Barnes is a consultant for and received royalties from Wright Medical. Scott Anseth is a consultant for Biomet.