Credit: Piotr Bodzek
A mobile compression device can prevent venous thromboembolism (VTE) after joint replacement surgery, according to research published in the Journal of Bone and Joint Surgery.
The device, called ActiveCare+S.F.T., delivers compressions to the leg that coordinate with a patient’s respiration rate, and this improves blood flow.
Of more than 3000 patients who used the device, with or without aspirin, less than 1% developed VTE.
When the researchers compared this rate to VTE rates observed in previous studies of warfarin, enoxaparin, rivaroxaban, and dabigatran, they found the device to be noninferior to anticoagulant therapy.
“Blood thinners have long been considered the standard of care to prevent blood clots after orthopedic surgery, but they can have side effects that are concerning for many patients,” said study author Clifford Colwell, MD, of the Scripps Clinic in La Jolla, California.
“Through this research, we have found and established an equally effective means of accomplishing the same goal, with an added layer of safety for patients.”
Dr Colwell and his colleagues established a registry of 3060 patients to determine the rate of symptomatic VTE after primary knee arthroplasty (n=1551) or hip arthroplasty (n=1509) performed at 10 different sites.
All of the patients enrolled were 18 years of age or older. They had no known history of VTE, coagulation disorders, or solid tumor malignancies.
Patients wore the ActiveCare+S.F.T device both during and after surgery, for a minimum of 10 days. The researchers evaluated patients at 3 months after their surgery to document evidence of deep vein thrombosis (DVT) or pulmonary embolism (PE).
In all, 28 patients (0.92%) developed VTE. Twenty patients had distal DVT, 3 had proximal DVT, and 5 had PE. One patient died of coronary failure, but there was no autopsy, so it is not clear if the patient developed a PE.
Overall, the rate of VTE with the compression device—0.92%—was considered noninferior to rates previously observed with anticoagulants—2.2% for warfarin, 1.1% for enoxaparin, 0.64% for rivaroxaban, and 1.2% for dabigatran.
However, among patients who underwent knee arthroplasty, the device fell short of the noninferiority margin (1.0%) for rivaroxaban by 0.06%.
The device’s manufacturer, Medical Compression Systems Inc., funded the registry used in this study but did not have a role in the registry design or protocol. And the researchers did not receive compensation from the manufacturer.
