Woolson ST, Watt JM.
Intermittent pneumatic compression to prevent proximal deep venous thrombosis
during and after total hip replacement. A prospective, randomized study of
compression alone, compression and aspirin, and compression and low-dose warfarin.
J Bone Joint Surg Am 1991 Apr;73(4):507-12

Stanford University Hospital, California.

A prospective, randomized study of the effectiveness of intraoperative and
postoperative use of intermittent pneumatic compression, alone or in combination
with oral administration of either aspirin or low-dose warfarin, was done of a
consecutive series of patients who had a total hip replacement and were more than
thirty-nine years old. All patients began walking by the third postoperative day.
One hundred and ninety-six patients who had 217 total hip arthroplasties were
included. Twenty-eight per cent of the procedures were revisions of a previous
total hip replacement or of an endoprosthesis, and the remainder were primary
arthroplasties. Patients were randomized as to the type of prophylaxis that they
received: intermittent pneumatic compression alone, seventy-six hips;
intermittent pneumatic compression and aspirin, seventy-two hips; or intermittent
pneumatic compression and low-dose warfarin, sixty-nine hips. Before discharge
from the hospital, and at an average of seven days after the operation, all
patients were evaluated for the presence of proximal deep-vein thrombosis with
either venography on the side of the operation or with bilateral venous
ultrasonography. The relative frequency with which thrombosis occurred in a
proximal vein was not significantly different in the three groups; the over-all
relative frequency was 10 per cent. Intermittent compression during and after the
operation effectively reduces the rate of proximal-vein thrombosis after total
hip replacement. With the number of patients in our study, the effectiveness of
this technique could not be shown to be augmented by oral administration of
either aspirin or low-dose warfarin.