Stannard JP, Harris RM, Bucknell AL, Cossi A, Ward J, Arrington ED.
Prophylaxis of deep venous thrombosis after total hip arthroplasty by using
intermittent compression of the plantar venous plexus.
Am J Orthop 1996 Feb;25(2):127-34

Orthopedic Trauma Service, Brooke Army Medical Center, San Antonio, Texas, USA.

A randomized, prospective, blinded study comparing the efficacy of prophylaxis of
deep venous thrombosis by using (A) heparin-aspirin therapy, (B) intermittent
pulsatile pneumatic-pump compression of the plantar venous plexus, or (C) both
methods, was conducted in patients undergoing elective total hip replacement
arthroplasty. Duplex ultrasonography was obtained in all 75 patients before
surgery, at 1 week, and 2 weeks after surgery, to detect the presence or absence
of deep venous thrombosis, with venograms confirming all positive results. Five
of 25 patients in group A (heparin-aspirin) developed deep vein thrombosis. No
deep venous thrombi were detected in groups B or C. One pulmonary embolus was
detected in group A. The reduction in detectable deep venous thrombosis by the
use of intermittent compression of the plantar venous plexus was significant.
Wound drainage was decreased by 2 to 3 days (P < 0.05) in group B. It is
concluded that, in this group of 75 consecutive patients, intermittent pulsatile
compression of the plantar venous plexus was superior to heparin/aspirin
pharmacologic prophylaxis for the prevention of deep venous thrombosis proximal
to the calf.