Westrich GH, Specht LM, Sharrock NE, Sculco TP, Salvati EA,
Pellicci PM, Trombley JF, Peterson M.
Pneumatic compression hemodynamics in total hip arthroplasty.
Clin Orthrop 2000 Mar(372) :180-91

Hospital for Special Surgery, New York, NY 10021, USA.

A crossover study was performed to evaluate the effect of several pneumatic
compression devices and active dorsoplantar flexion in 10 patients who underwent
total hip arthroplasty. Using the Acuson 128XP/10 duplex ultrasound unit with a
5-MHz linear array probe, peak venous velocity and venous volume were assessed
above and below the greater saphenous vein and common femoral vein junction. A
computer generated randomization table was used to determine the order of the
test conditions. The pneumatic compression devices evaluated included two foot
pumps, one foot and calf pump, one calf pump, and three calf and thigh pumps.
Statistical analyses included analysis of variance and analysis of variance with
covariance between devices and patients. The covariates tested were the baseline
measurements and the order in which the devices were tested. Differences between
devices relate in part to the frequency and rate of inflation and the location
and type of compression. Pulsatile calf and foot and calf pneumatic compression
with a rapid inflation time produced the greatest increase in peak venous
velocity, whereas compression of the calf and thigh showed the greatest increase
in venous volume. Because patient and nursing compliance is essential to the
success of mechanical prophylaxis for thromboembolic disease, the more simple,
yet efficacious, devices that are easier to apply and less cumbersome appear to
have a greater likelihood of success. In the active and alert patient, active
dorsoplantar flexion should be encouraged.