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The Use of Intermittent Pneumatic Compression in Orthopaedic Surgery: An Umbrella Review and Meta-Analysis.
Michael Yayac1, Tyler Konen1, Javad Parvizi2
1Department of Orthopedic Surgery, Inspira Health, Vineland, New Jersey.
JB & JS Open Access
|July 10, 2026
Summary
Intermittent pneumatic compression (IPC) devices effectively reduce venous thromboembolism (VTE) and bleeding risks in orthopaedic surgery patients. IPC offers a safer alternative to pharmacological prophylaxis, especially for high-risk individuals.
Area of Science:
- Orthopaedic Surgery
- Vascular Surgery
- Medical Devices
Background:
- Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), is a significant complication post-orthopaedic surgery.
- Intermittent pneumatic compression (IPC) devices are a common non-pharmacological method for VTE prophylaxis, but evidence of their efficacy is inconsistent.
- VTE contributes to increased patient morbidity, mortality, and healthcare expenses.
Purpose of the Study:
- To conduct an umbrella review of meta-analyses to evaluate the effectiveness and safety of IPC devices for VTE prophylaxis in orthopaedic surgery.
- To compare IPC with no prophylaxis, chemoprophylaxis, and combination regimens.
- To assess the impact of IPC on DVT, PE, bleeding complications, and mortality.
Main Methods:
- An umbrella review following PRISMA guidelines, systematically searching PubMed, Embase, and Cochrane databases.
- Inclusion of meta-analyses comparing IPC devices to other prophylactic strategies in orthopaedic surgery patients.
- Evaluation of study quality, primary study overlap, and reporting bias, followed by a meta-analysis of primary studies.
Main Results:
- IPC significantly decreased the risk of all DVT (OR 0.40), proximal DVT (OR 0.58), distal DVT (OR 0.45), PE (OR 0.45), and bleeding complications (OR 0.57).
- No significant effect on mortality was observed.
- Subgroup analyses indicated IPC's effectiveness across various surgeries and interventions, showing particular benefits over aspirin and low molecular weight heparin, and comparable or superior performance to chemoprophylaxis regarding bleeding risk.
Conclusions:
- IPC devices are effective in reducing VTE and bleeding complications in orthopaedic patients, offering a more favorable safety profile than pharmacological agents.
- Existing evidence shows heterogeneity, underscoring the need for high-quality, standardized randomized trials.
- The findings support the continued use of IPC, especially for patients with high bleeding risk or contraindications to chemoprophylaxis.
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