Efficacy in Deep Vein Thrombosis Prevention With Extended Mechanical Compression Device Therapy and Prophylactic Aspirin Following Total Knee Arthroplasty: A Randomized Control Trial

Snyder, Mark A.; Sympson, Alexandra N.; Scheuerman, Christina M.; Gregg, Justin; Hussain, Lala R.

doi:10.1016/j.arth.2016.12.027

Cited by 45 publications

(45 citation statements)

References 15 publications

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“… 62 A randomized control trial examining the effects of 6 weeks of MCD in patients receiving 325 mg aspirin twice daily for 3 weeks demonstrated a significantly lower incidence of deep vein thrombosis (DVT) (0 vs 23.1%) for patients with MCD than without. 63 …”

Section: Cardiac Optimization and Vte Prophylaxismentioning

confidence: 99%

Total knee arthroplasty: improving outcomes with a multidisciplinary approach

Feng¹,

Novikov²,

Anoushiravani³

et al. 2018

JMDH

121

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Total knee arthroplasty (TKA) is the most commonly performed inpatient surgical procedure within the USA and is estimated to reach 3.48 million procedures annually by 2030. As value-based care initiatives continue to focus on hospital readmission rates and patient satisfaction, it has become essential for health care providers to develop and implement a multidisciplinary approach to enhance TKA outcomes while minimizing unnecessary expenditures. Through this necessity, clinical care pathways have been developed to standardize, organize, and improve the quality and efficiency of patient care while simultaneously encouraging the collaboration among various medical care providers. Here, we review several systems based programs and specialty care practices that can be adopted into the standard orthopedic practice.

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Section: Cardiac Optimization and Vte Prophylaxismentioning

confidence: 99%

Total knee arthroplasty: improving outcomes with a multidisciplinary approach

Feng¹,

Novikov²,

Anoushiravani³

et al. 2018

JMDH

121

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“…There are few studies that deal with the use of aspirin for the prevention of early post-operative DVT. 34 , 168 Studies evaluating the incidence of DVT, including asymptomatic DVT, in the early post-operative period use DVT as a surrogate endpoint for PE. These studies are mostly conducted by pharmaceutical companies in their effort to gain regulatory approval for the agents.…”

Section: Is the Use Of Aspirin For The Prevention Of Vte Accepted By mentioning

confidence: 99%

Aspirin and the prevention of venous thromboembolism following total joint arthroplasty

Azboy

Barrack

Thomas

et al. 2017

The Bone & Joint Journal

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The number of arthroplasties being performed increases each year. Patients undergoing an arthroplasty are at risk of venous thromboembolism (VTE) and appropriate prophylaxis has been recommended. However, the optimal protocol and the best agent to minimise VTE under these circumstances are not known. Although many agents may be used, there is a difference in their efficacy and the risk of bleeding. Thus, the selection of a particular agent relies on the balance between the desire to minimise VTE and the attempt to reduce the risk of bleeding, with its undesirable, and occasionally fatal, consequences.Acetylsalicylic acid (aspirin) is an agent for VTE prophylaxis following arthroplasty. Many studies have shown its efficacy in minimising VTE under these circumstances. It is inexpensive and well-tolerated, and its use does not require routine blood tests. It is also a ‘milder’ agent and unlikely to result in haematoma formation, which may increase both the risk of infection and the need for further surgery. Aspirin is also unlikely to result in persistent wound drainage, which has been shown to be associated with the use of agents such as low-molecular-weight heparin (LMWH) and other more aggressive agents.The main objective of this review was to summarise the current evidence relating to the efficacy of aspirin as a VTE prophylaxis following arthroplasty, and to address some of the common questions about its use. There is convincing evidence that, taking all factors into account, aspirin is an effective, inexpensive, and safe form of VTE following arthroplasty in patients without a major risk factor for VTE, such as previous VTE.Cite this article: Bone Joint J 2017;99-B:1420–30.

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“…Çalışma grubunda mekanik profilaksi ameliyat sonrası altı hafta, kontrol grubundaysa yalnızca hastanede yatış süresince uygulanmış; mekanik profilaksiyi altı hafta süreyle kullanan grupta asemptomatik DVT'ye rastlanmazken, bu oran kontrol grubunda %23 olarak saptanmıştır. [45] Yalnızca kompresyon cihazı kullanımının DVT profilaksisindeki etkinliğini, kemoprofilaksi ajanları ile karşılaştıran bir çalışmayla karşılaşılmamıştır. Çok merkezli bir çalışmada, TDA hastalarına ameliyat sonrası en az 10 gün süreyle (cerrahın tercihine göre ASA ile birlikte ya da tek başına) taşınabilir kompresyon cihazıyla mekanik profilaksi uygulanmış ve 90 günlük izlemde olguların %1,6'sında semptomatik DVT, %0,13'ünde PE geliştiği saptanmıştır; bu oranlar literatürde yer bulmuş olan warfarin, enoksaparin, rivaroksaban ve dabigatran gibi kemoprofilaktik ajanlarla elde edilen korunma başarısıyla karşılaştırıldığında, mekanik kompresyonun rivaroksaban dışındaki tüm ajanlarla benzer korunma sağladığı sonucuna varılmıştır.…”

Section: Zayıf öNeri-2cunclassified