Hull RD, Raskob GE, Gent M, McLoughlin D, Julian D, Smith FC,
Dale NI, Reed-Davis R, Lofthouse RN, Anderson C.
Effectiveness of intermittent pneumatic leg compression for preventing deep vein
thrombosis after total hip replacement.
JAMA 1990 May 2;263(17):2313-7

Division of General Internal Medicine, University of Calgary, Canada.

A randomized trial was performed in consecutive patients undergoing total hip
replacement to evaluate the effectiveness of sequential intermittent calf and
thigh compression for preventing venous thrombosis compared with a control group
given no prophylaxis. Both groups underwent case finding for deep vein thrombosis
using combined fibrinogen I 125 leg scanning, impedance plethysmography, and
venography. Deep vein thrombosis by venography was present in 77 (49%) of 158
control patients compared with 36 (24%) of 152 patients given intermittent
compression. Proximal vein thrombosis was present in 42 controls (27%) compared
with 22 patients (14%) given intermittent compression. Combined impedance
plethysmography and leg scanning was insensitive in this patient group
(sensitivity, 46%); venography was required to detect more than half the patients
with venous thrombosis. Sequential intermittent leg compression clinically and
statistically significantly reduced the frequency of both proximal vein and calf
vein thrombosis. Case finding resulted in early detection and treatment of
patients with venous thrombosis.