Larson CM, MacMillan DP, Lachiewicz PF.
Thromboembolism after total knee arthroplasty: intermittent pneumatic compression
and aspirin prophylaxis.
J South Orthop Assoc 2001 Fall;10(3):155-63; discussion 163

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

This is a study of two consecutive antithromboembolism regimens after total knee
arthroplasty. In group 1, 131 patients were given aspirin prophylaxis alone (650
mg by mouth twice a day). In group 2, 123 patients were treated with aspirin,
knee-high compression stockings, and intermittent knee-high pneumatic compression
devices, which were started intraoperatively. The prevalence of deep vein
thrombosis in group 1 was 15.9% (21 of 131 patients). One patient had a possible
symptomatic nonfatal pulmonary embolism, and one patient had a symptomatic calf
thrombus. Asymptomatic thrombi were detected in calf veins in 9 patients,
popliteal vein in 6 patients, and femoral vein in 5 patients. In Group 2, the
prevalence was 7.4% (9 of 123 patients). Asymptomatic thrombi were located in
calf veins in 6 patients, popliteal vein in 1 patient, and femoral vein in 2
patients. There was a significant difference in the prevalence of deep vein
thrombosis between the two groups. A history of previous thromboembolism was a
significant risk factor for a new thrombus. The prevalence after bilateral
one-stage knee arthroplasty was 24.3% for group 1 and 12.5% for group 2. Aspirin
and knee-high intermittent pneumatic compression together are more effective than
aspirin alone for prevention of deep vein thrombosis after primary and revision
knee arthroplasty.