Lachiewicz PF, Klein JA, Holleman JB Jr, Kelley S.
Pneumatic compression or aspirin prophylaxis against thromboembolism in total hip
arthroplasty.
J South Orthop Assoc 1996 Winter:5(4):272-80

Division of Orthopaedic Surgery, University of North Carolina School of Medicine,
Chapel Hill 27599-7055, USA.

We prospectively studied the use of either aspirin or intermittent pneumatic
compression (IPC) as prophylaxis against thromboembolism after 330 consecutive
total hip arthroplasties. Duplex ultrasonography of the veins of both lower
extremities and ventilation-perfusion lung scans were done preoperatively and 7
to 14 days postoperatively. Eight patients in the IPC group (5%) had asymptomatic
deep vein thrombosis; there were no symptomatic thrombi. In the aspirin group, 10
patients (7%) had asymptomatic deep vein thrombosis and two patients (1%) had
symptomatic deep vein thrombosis. This difference was not statistically
significant. There were no fatal pulmonary emboli in either group. In the IPC
group, only one patient had symptomatic pulmonary embolism and 20 patients (22
hips [12%]) had asymptomatic pulmonary embolism. In the aspirin group, two
patients (1%) had symptomatic pulmonary embolism and 26 patients (18%) had
asymptomatic pulmonary embolism. This difference in asymptomatic pulmonary
embolism between the two groups was statistically significant. Both groups had a
low incidence of deep vein thrombosis, as shown by Duplex ultrasonography, but
IPC was more effective than aspirin in preventing asymptomatic pulmonary embolism
after total hip arthroplasty.