Deep Vein Thrombosis Prevention in Joint Arthroplasties: Continuous Enhanced Circulation Therapy vs Low Molecular Weight Heparin

Gelfer, Yael; Tavor, Hovav; Oron, Amir; Peer, Amir; Halperin, Nahum; Robinson, Dror

doi:10.1016/j.arth.2005.04.031

« Previous Next »The Journal of Arthroplasty
Volume 21, Issue 2 , Pages 206-214, February 2006

Deep Vein Thrombosis Prevention in Joint Arthroplasties:

Continuous Enhanced Circulation Therapy vs Low Molecular Weight Heparin

Yael Gelfer, MD
- Department of Orthopedics, Assaf Harofe Medical Center, Zeriffin, Israel
- Department of Orthopedics, Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
Hovav Tavor, MD
- Department of Orthopedics, Assaf Harofe Medical Center, Zeriffin, Israel
- Department of Orthopedics, Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
Amir Oron, MD
- Department of Orthopedics, Assaf Harofe Medical Center, Zeriffin, Israel
- Department of Orthopedics, Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
Amir Peer, MD
- Department of Invasive Radiology, Assaf Harofe Medical Center, Zeriffin, Israel
- Department of Orthopedics, Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
Nahum Halperin, MD
- Department of Orthopedics, Assaf Harofe Medical Center, Zeriffin, Israel
- Department of Orthopedics, Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
Dror Robinson, MD, PhD
- Department of Orthopedics, Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
- Department of Orthopedics, Rabin Medical Center, Campus Golda, Israel
- Reprint requests: Dror Robinson, MD, PhD, Department of Orthopedics, Rabin Medical Center, Campus Golda, Petah Tikwa, Israel.

Received 23 February 2004; accepted 19 April 2005.

Abstract

Deep vein thrombosis prevention efficacy using a new, miniature, mobile, battery-operated pneumatic system (continuous enhanced circulation therapy [CECT] system) combined with low-dose aspirin was compared to enoxaparin. One hundred twenty-one patients who underwent total hip or knee arthroplasty were prospectively randomized into 2 groups. The study group was treated by the CECT system starting immediately after the induction of anesthesia. Postoperatively, a daily 100-mg aspirin tablet was added. The control group received 40 mg of enoxaparin per day. Bilateral venography was performed at the fifth to eight postoperative day. In the CECT group, as compared to the enoxaparin group, there was a significantly lower overall rate of DVT and proximal DVT. Safety profiles were similar in both groups. The combination of the CECT device with low-dose aspirin is more effective than enoxaparin in preventing deep-vein thrombosis after lower limb arthroplasties.

Key words: deep vein thrombosis, low molecular weight heparin, arthroplasty, total knee arthroplasty, total hip arthroplasty, aspirin, continuous enhanced circulation therapy, intermittent pneumatic compression, compliance