Intermittent pneumatic compression reduces the risk of deep vein thrombosis during post-operative lower limb immobilisation : a prospective randomised trial of acute ruptures of the Achilles tendon

Deep vein thrombosis is a common complication when immobilising the lower limb after surgery. We hypothesised that adjuvant intermittent pneumatic compression (IPC) during post-operative outpatient immobilisation of the lower limb could reduce the incidence of deep vein thrombosis (DVT). A total of 150 patients with acute Achilles tendon rupture were randomised to either treatment with IPC for six hours daily (n = 74) under an orthosis or treatment as usual (n = 74) in a plaster cast. At two weeks post-operatively the incidence of DVT was assessed using compression duplex ultrasound (CDU) by two ultrasonographers blinded to treatment. After the IPC intervention had ended, all patients were immobilised in the orthosis for another four weeks and a second CDU was performed. Trial registration: www.clinicaltrials.gov; NCT01317160. At two weeks the DVT rate was 21% in the IPC group and 38% in the control group (OR = 2.36; 95% CI 1.11 to 5.01). Age > 39 years was found to be a strong risk factor for DVT (OR = 4.84; 95% CI 2.14 to 10.96). Treatment with IPC corrected for age reduced the risk significantly (OR = 0.36; 95% CI 0.16 to 0.80). At six weeks, however, the frequency of DVT was 49% in the IPC group and 51% in the control group (OR = 0.94; 95% CI 0.49 to 1.83). IPC seems to be an effective method of reducing the risk of early DVT in leg-immobilised outpatients. A high risk of DVT during prolonged immobilisation warrants further study.

In:The Bone & Joint JournalStockholm : Karolinska Institutet, Dept of Molecular Medicine and Surgery97B97-B:5, s. 675-6802049-4394
In:The bone & joint journalStockholm : Karolinska Institutet, Dept of Molecular Medicine and Surgery97B97-B:5, s. 675-6802049-4408

By the author/editor: Domeij-Arverud, ...; Latifi, Ali; Labruto, Fausto; Nilsson, Gunnar; Edman, Gunnar; Ackermann, Paul ...

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