Are Elastic Restraints Still Necessary in Improved Rehabilitation Programs After Hip and Knee Prosthetic Surgery?

Launched by CLINIQUE PASTEUR LANROZE · Aug 19, 2024

Keywords

ClinConnect Summary

This clinical trial is looking at whether using only medication to prevent blood clots after hip and knee replacement surgery is as effective as using both medication and elastic compression stockings. Blood clots, known as venous thrombosis, and their serious complications, like pulmonary embolism, are risks after surgery. In recent studies, it seems that the stockings may not provide extra benefits for preventing these clots, so this trial will help clarify if medication alone is sufficient for patients.

To participate in this study, individuals aged 65 to 74 who are scheduled for their first hip or knee replacement surgery and are part of a specialized rehabilitation program may qualify. However, those with certain health conditions, like obesity, heart failure, or those who need long-term blood thinners, will not be eligible. Participants can expect to be monitored for up to 90 days after their surgery to see how well the medication works in preventing blood clots. This trial is important because it could help streamline recovery methods and improve patient care after surgery.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • first line and non-traumatic total hip or knee arthroplasty
• • Patient included in an Enhanced Rehabilitation after Surgery (ERS) or "fast-track" protocol, or scheduled as an outpatient.
• Exclusion Criteria:
• • Patient requiring long-term anticoagulation for pre-existing co-morbidity
• • Patients with coagulation disorders (hypercoagulability)
• • Patient undergoing thrombogenic pharmacological treatment
• • History of obliterative arteriopathy of the lower limbs
• • Arterial disease
• • Obesity
• • Heart failure
• • Chronic bronchopneumopathy
• • Lymphedema
• • Chronic inflammatory disease
• • Permanent wearing of elastic restraints
• • Proximal or distal arterial bypass surgery
• • Creatinine clearance \< 15 ml/min
• • Inability to give consent
• • Revision surgery for hip or knee prosthesis
• • Metastatic cancer
• • Life expectancy less than 3 months
• • Allergy to socks or compression stockings
• • Patients presenting one or more exclusion criteria for the fast-track protocol (severe or poorly-balanced associated conditions such as diabetes or immunodepression, inability to contact the doctor or hospital department if necessary, pre-operative ASA score greater than or equal to 4).
• • Adults under guardianship or curatorship
• • Vulnerable persons in accordance with article L1121-6 of the CSP (French Public Health Code)