抄録
Objective: From April 2005, we evaluated the rate of venous thromboembolism (VTE) in all total hip arthroplasty (THA) cases using multi detector computed tomography (CT) scans on postoperative day one. We report two original physical therapy methods, namely intermittent calf massage (ICaM) and intermittent passive ankle motion (IPAM), that have proven to be highly effective for VTE prophylaxis.
Methods: 868 THA cases from April 2005 to June 2013 were included for analysis. Graduated compression stockings and intermittent pneumatic compression were used postoperatively in all cases. In cases prior to 2007, no VTE prophylaxis methods were used in a traditional posterolateral approach (Group I: n=179). Elastic bandages were used during surgery in cases from 2007 to 2011 with a minimally invasive approach (Group II: n=506). From 2011, ICaM and IPAM were additionally performed (Group III: n=183). VTE incidence rate, age, sex, operation time, and blood loss were compared between the three groups.
Results: The incidence rate of VTE was 30.2% (54 cases) in Group I, 15.6% (79 cases) in Group II, and 0.5% (1 case) in Group III, presenting a significant decrease in VTE by applying ICaM and IPAM. Operation time was significantly longer in the Group I. VTE positive patients were also significantly older in all three groups.
Conclusion: In our study, the incidence rate of VTE was reduced by 50% through a decrease in operation time and the use of elastic compression bandages (Group II). Furthermore, the incidence rate of VTE was reduced considerably to 0.5% through the simple use of ICaM and IPAM methods (Group III). ICaM and IPAM are highly effective methods for VTE prophylaxis and we hope to see it applied worldwide.
Summary: We report two original physical therapy methods, intermittent calf massage and passive ankle motion that have proven to be highly effective for VTE prophylaxis during total hip arthroplasty.
