In these consecutive patients we used IPC for mechanical prophylaxis of VTE. The purpose of this study was to evaluate the incidence of asymptomatic and symptomatic VTEs after the use of IPC device in a consecutive cohort who underwent primary THA and determined the effectiveness of this device by comparing the incidence of symptomatic VTE with previous data without prophylaxis as a historical control.įrom January 2010 to December 2013, 876 primary THAs (746 patients) were done at our department. The incidence of fatal PE, symptomatic PE, and symptomatic DVT was 0%, 0.1%, and 0.8%, respectively. Previously, we have reported low incidence rates of DVT and PE in East Asian patients after THA without thromboprophylaxis ( 18). However, the relative effectiveness of IPC as a prophylaxis against thrombosis after THA is still unclear. Mechanical prophylaxis with use of IPC device carries little risk of bleeding or hematoma formation on postoperative patients. IPC devices also enhance fibrinolytic activities, and reduce the risk of DVT ( 16, 17). These devices enhance venous drainage and prevent venous stasis from the lower extremities, which improves blood flow velocity 50% to 250% in the femoral vein ( 15). Intermittent pneumatic compression (IPC) devices have been utilized to manage swelling since the early 1950s ( 14). Although routine chemoprophylaxis is not recommended in all patients, a prophylaxis is necessary to prevent postoperative VTE after THA even in East Asian patients. Although the incidence of VTE is low in East Asia, VTE frequently leads to serious morbidity and mortality. As the dietary pattern of East Asians is westernizing, the incidence of diseases such as incidence of myocardial infarction and some cancers have increased ( 13). In East Asian countries, the occurrence of symptomatic VTE after THA is rare even without any thromboprophylaxis ( 10, 11, 12). The American Academy of Orthopaedic Surgeons (AAOS) ( 7), the American College of Chest Physicians (ACCP) ( 6), and the National Institute for Health and Clinical Excellence (NICE) ( 8), have recommended routine use of medical thromboprophylaxis, However, pharmacologic agents such as antiplatelet drugs, low-molecular-weight heparin, or warfarin are associated with complications, including bleeding, hematoma formation and infection of surgical site ( 9). VTEs are frequently asymptomatic and imaging studies have detected DVT and PE in 40% to 79% and in 7% to 30%, respectively, among THA patients without pharmaco-prophylaxis ( 3, 4, 5, 6). In western countries, the incidence of symptomatic venous thromboembolism (VTE) after THA is about 3% among patients who do not receive any thromboprophylaxis ( 1, 2). Deep vein thrombosis (DVT) and pulmonary embolism (PE) are well known complications after total hip arthroplasty (THA).
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