Lynch JA, Baker PL, Polly RE, Lepse PS, Wallace BE, Roudybush D, Sund K, Lynch NM.
Mechanical measures in the prophylaxis of postoperative thromboembolism in total
knee arthroplasty.
Clin Orthop 1990 Nov;(260):24-9

Orthopedic Associates, P.A., Topeka, KS 66606.

Total knee arthroplasty patients are at high risk for deep venous thrombosis and
pulmonary embolism. Prophylaxis against deep venous thrombosis and pulmonary
embolism in these patients seems mandatory. Pharmacologic agents such as dextran
40, aspirin, and warfarin are effective but may be associated with significant
complications such as drug reaction, bleeding, hematoma, and hemarthrosis.
Heparin was not effective and was associated with significant bleeding
complications. Mechanical methods such as continuous passive motion and
sequential pneumatic compression stockings were without complications and seemed
equal to or more effective than pharmacologic agents. Adding warfarin to
mechanical methods did not seem to augment the antithromboembolic effect of the
mechanical methods.