Macaulay W, Westrich G, Sharrock N, Sculco TP, Jhon PH, Peterson MG, Salvati EA.
Effect of pneumatic compression on fibrinolysis after total hip arthroplasty.
Clin Orthop 2002 Jun;(399):168-76

Center for Hip and Knee Replacement, Columbia University, PH 11th Floor, Rm 1146,
622 West 168th Street, New York, NY 10032, USA.

The purpose of this prospective randomized clinical study was to investigate the
enhanced systemic fibrinolysis mechanism of venous thrombosis prevention by
pneumatic compression after total hip arthroplasty. Fifty patients were
randomized into one of two groups (one with pneumatic compression [n=25] and one
without [n=25]). Blood was drawn from a radial arterial line immediately
preoperatively (baseline), at skin closure, and 8 hours and 22 hours after the
baseline sample. Serum determinations of antigen of tissue plasminogen activator
and plasminogen activator inhibitor-1 were done using enzyme-linked immunosorbent
assays. These data do not support the enhancement of systemic fibrinolysis
mechanism for lowering thromboembolic risk after total hip arthroplasty by
pneumatic compression devices. The results of this study showed no differences
that were statistically significant between the two groups. The greatest
difference was observed 8 hours after surgery for the plasminogen activator
inhibitor-1 marker, (28.12 with compression versus 22.07 ng/mL without); however,
this result was not statistically significant. The beneficial effect of
mechanical compression is more likely achieved through increased flow, local
fibrinolytic effects, or both.