Less deep vein thrombosis due to transcutaneous fibular nerve stimulation in total knee arthroplasty: a randomized controlled trial View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-06-24

AUTHORS

Masashi Izumi, Masahiko Ikeuchi, Koji Aso, Natsuki Sugimura, Yuko Kamimoto, Tetsuya Mitani, Tadashi Ueta, Takayuki Sato, Masataka Yokoyama, Tetsuro Sugiura, Toshikazu Tani

ABSTRACT

PurposeIt has been known for years that deep vein thrombi (DVT) start to develop during total joint arthroplasty. Previously, we reported effective prevention of venous stasis by transcutaneous electrical nerve stimulation (TENS). It is hypothesized that TENS might be a thromboprophylactic tool for the limb undergoing surgery. The purpose of this study is to clarify the clinical efficacy and safety of TENS in patients during total knee arthroplasty (TKA).MethodsNinety patients undergoing primary TKA were involved and randomly allocated to the TENS or control group. In the TENS group, electrical stimulation of the common fibular nerve, which produced a brisk dorsiflexion of the ankle, was performed for the operated leg during surgery. In the control group, no electrical stimulation was applied. Serum D-dimer and soluble fibrin monomer complex (SFMC) levels were measured before surgery, immediately after surgery, and post-operative day (POD) 1. Ultrasonography was performed on POD 1.ResultsImmediately after surgery, D-dimer and SFMC levels of each group were significantly lower in the TENS group compared with control (p < 0.05). The incidence of DVT was 11 % (five cases) in the TENS group while 31 % (14 cases) in control (p = 0.02). There were no adverse effects related to TENS.ConclusionsTENS during TKA showed significant effects on preventing DVT. Sustaining muscle pump activation during surgery prevented not only venous stasis, but also hypercoagulability of blood. Intraoperative TENS is a safe and novel strategy against early post-operative thromboembolism, which is difficult to be completed through existing prophylaxis after total joint arthroplasty.Level of evidenceRandomized controlled trial, Level I. More... »

PAGES

3317-3323

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00167-014-3141-z

DOI

http://dx.doi.org/10.1007/s00167-014-3141-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1051958004

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/24957913


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