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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 7, 887-892.
doi: 10.1302/0301-620X.89B7.18556  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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The use of graduated compression stockings in association with fondaparinux in surgery of the hip

A MULTICENTRE, MULTINATIONAL, RANDOMISED, OPEN-LABEL, PARALLEL-GROUP COMPARATIVE STUDY

A. T. Cohen, MSc, MD, FRACP, Consultant Vascular Physician1; J. A. Skinner, FRCS, FRCS(Orth), Consultant Orthopaedic Surgeon2; D. Warwick, MD, FRCS, FRCS(Orth), Consultant Orthopaedic Surgeon3; and I. Brenkel, MBChB, FRCSEd, Orthopaedic Surgeon4

1 Department of Vascular Surgery, King’s College Hospital, Bessemer Road, London SE5 9RS, UK.
2 Royal National Orthopaedic Hospital, Brockley Hill, Stanmore HA7 4LP, UK.
3 University of Southampton, Tremona Road, Southampton SO16 6UY, UK.
4 Department of Orthopaedics, Queen Margaret Hospital, Whitefield Road, Dunfermline KY12 0SU, UK.

Correspondence should be sent to Dr A. T. Cohen; e-mail: alexander.cohen{at}kcl.ac.uk

Little is known about the efficacy of graduated compression stockings in preventing venous thromboembolism after hip surgery. We conducted a prospective, randomised single-blind study to determine whether the addition of compression stockings to fondaparinux conferred any additional benefit.

The study included 874 patients, of whom 795 could be evaluated (400 in the fondaparinux group and 395 in the fondaparinux plus compression stocking group). Fondaparinux was given post-operatively for five to nine days, either alone or combined with wearing stockings, which were worn for a mean 42 days (35 to 49).

The study outcomes were venous thromboembolism, or sudden death before day 42. Duplex ultrasonography was scheduled within a week of day 42. Safety outcomes were bleeding and death from venous thromboembolism.

The prevalence of deep-vein thrombosis was similar in the two groups 5.5% (22 of 400) in the fondaparinux group and 4.8 (19 of 395) in the fondaparinux plus stocking group (odds ratio 0.88, 95% confidence interval 0.46 to 1.65, p = 0.69). Major bleeding occurred in only one patient.

The addition of graduated compression stockings to fondaparinux appears to offer no additional benefit over the use of fondaparinux alone.




This article has been cited by other articles:


Home page
 J Bone Joint Surg BrHome page
I. R. BOUTROS, P. R. LANDHAM, R. R. BROWN, and H. S. GOSALI
The use of graduated compression stockings in association with fondaparinux in surgery of the hip: a multicentre, multinational, randomised, open-label, parallel-group comparative study
J Bone Joint Surg Br, November 1, 2008; 90-B(11): 1535 - 1536.
[Full Text] [PDF]

Home page
 J Bone Joint Surg BrHome page
J. Daniel, A. Pradhan, C. Pradhan, H. Ziaee, M. Moss, J. Freeman, and D. J. W. McMinn
Multimodal thromboprophylaxis following primary hip arthroplasty: THE ROLE OF ADJUVANT INTERMITTENT PNEUMATIC CALF COMPRESSION
J Bone Joint Surg Br, May 1, 2008; 90-B(5): 562 - 569.
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eLetters:

Read all eLetters

A discussion on the role of chemical prophylaxis of thromboembolic disease
Augusto Sarmiento
J Bone Joint Surg Br Online, 5 Sep 2007 [Full text]
The use of graduated compression stockings in association with fondaparinux in surgery of the hip
Ihab R. Boutros, et al.
J Bone Joint Surg Br Online, 18 Oct 2007 [Full text]
Authors' reply:
Alexander T Cohen, et al.
J Bone Joint Surg Br Online, 20 Dec 2007 [Full text]

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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General