A Prospective Study of Venous Thromboembolic Prophylaxis Using Foot Pumps Following Total Knee Replacement in a Chinese Population

Abstract

Purpose: The purpose of this study was to evaluate foot pumps as mechanical prophylaxis for deep vein thrombosis (DVT) following total knee replacement (TKR) in a Chinese population. Methods: All consecutive patients following TKR during 2002–2006 received routine duplex ultrasound surveillance for DVT 9 days postoperatively. The demographic data and risk factors were recorded. No medication was given for DVT prophylaxis in all patients. Results: We evaluated 91 consecutive TKRs in 85 patients. Although 44 knee replacements (Group 1) done before December 2004 were not given foot pumps, 47 knee replacements (Group 2) done afterwards were given foot pumps. All patients were followed up for more than 6 months. DVT was detected in three cases (6.8%) in Group 1 compared with four knees (8.5%) in Group 2. Proximal thrombosis was observed in two knees (4.5%) in Group 1 compared with two knees (4.3%) in Group 2. No patient had pulmonary embolism. Six out of 59 (10.2%) patients who underwent the operations under general anaesthesia suffered from DVT, whereas one in 28 (3.6%) patients operated under spinal anaesthesia had DVT. All had no statistical significance. Conclusion: The rate of proximal DVT after TKR was low (4.5%) without pharmacological prophylaxis. We advise against the use of pharmacological prophylaxis in Chinese population for TKRs because of the low risk of proximal DVT and its possible bleeding complications. Foot pump did not lower the rate of DVTfurther, and its use for DVT prophylaxis in TKR is not necessary.

Keywords

• foot pumps
• total knee replacement
• venous thromboembolism prophylaxis