The Use of Intermittent Pneumatic Compression in Orthopaedic Surgery: An Umbrella Review and Meta-Analysis
Abstract
Background: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a major complication following orthopaedic surgery, contributing to increased morbidity, mortality, and healthcare costs. Intermittent pneumatic compression (IPC) devices are widely used as a nonpharmacological prophylactic intervention, yet the evidence regarding their effectiveness remains varied across studies.
Methods: An umbrella review of published meta-analyses was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Reviews comparing IPC devices to no prophylaxis, chemoprophylaxis, or combination regimens in orthopaedic surgery populations were identified through systematic searches of PubMed, Embase, and Cochrane databases. Data on DVT, PE, bleeding complications, and mortality were extracted. Study quality, overlap of primary studies, and reporting bias were evaluated. A meta-analysis of primary studies was performed.
Results: IPC significantly reduced the risk of all DVT (odds ratio [OR] 0.40), proximal DVT (OR 0.58), distal DVT (OR 0.45), PE (OR 0.45), and bleeding complications (OR 0.57), with no effect on mortality. Subgroup analyses showed that IPC was effective across most surgery and intervention types, with particular benefit over aspirin and low molecular weight heparin. IPC alone performed comparably or better than chemoprophylaxis, especially for bleeding risk.
Conclusion: IPC devices are…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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