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Venous thrombosis after elective hip replacement -- the influence of preventive intermittent calf compression and of surgical technique
Gallus A, Raman K, Darby T
The British Journal of Surgery 1983 Jan;70(1):17-19
clinical trial
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

The effect of preventive intermittent calf compression on the incidence, distribution and extent of venous thrombosis after elective hip replacement was examined by randomized trial in 90 patients who were screened for postoperative thrombosis with 125I-fibrinogen leg scanning and impedance plethysmography, followed by routine venography on the seventh postoperative day. Venography showed that leg compression reduced the incidence of calf vein thrombosis from 45% (21/47) in untreated patients to 16% (7/43) (p < 0.005), but not that of proximal (ie, popliteal or femoral) vein thrombosis, which occurred in 23% of treated and 26% of untreated patients. However, proximal vein thrombosis appeared to be less extensive in treated patients. Proximal vein thrombosis was found in 40% of patients who had hip replacement by a modified Charnley technique (17/43 patients), and 9% of patients in whom a posterior surgical approach was used (4/43 patients) (p < 0.005), strongly suggesting that surgical technique may influence the proximal vein thrombosis rate after elective hip replacement.

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