Fujisawa M, Naito M, Asayama I, Kambe T, Koga K.
Effect of calf-thigh intermittent pneumatic compression device after
total hip arthroplasty: comparative analysis with plantar
compression on the effectiveness of reducing thrombogenesis and
leg swelling.
J Orthop Sci. 2003;8(6):807-11.

Department of Orthopaedic Surgery, Fukuoka University School of
Medicine, 45-1 Nanakuma, Johnan-ku, Fukuoka 814-0180, Japan.
The purpose of this study was to evaluate the efficacy of two
intermittent pneumatic compression devices as prophylaxis
against intravascular coagulation and leg swelling following total
hip arthroplasty. We studied 121 patients by assessing
thrombogenesis using the D-dimer level before and after total hip
arthroplasty. In addition, the patients' postoperative swelling was
evaluated by measuring the thigh and lower leg circumference.
Altogether, 58 patients were assigned to the calf-thigh pneumatic
compression group, and the other 63 were assigned to the plantar
compression group; the two pneumatic compression devices were
compared to evaluate which was more effective for reducing
thrombogenesis. At 7 days postoperatively, the mean D-dimer
levels of the calf-thigh compression group and the plantar
compression group were 8.86 and 9.26 microg/ml, respectively.
There was no significant difference ( P = 0.697) between the two
groups. However, the increased ratio of the circumference of the
thigh, which was compared after arthroplasty, averaged 1.22% in
the calf-thigh compression group and 3.19% in the plantar
compression group, which was significantly different ( P << 0.01).
Calf-thigh pneumatic compression was found to be more effective
than plantar compression for reducing thigh swelling during the
early postoperative stage.