Four patients needed transfusions (three receiving enoxaparin), one had infection and one hemarthrosis (both in the enoxaparin group). There was no case of symptomatic venous thromboembolism. We randomized 150 patients and lost 3 to follow-up with enoxaparin and 2 with IPCD. Blood loss (volume accumulated in the suction drain and drop of hemoglobin and hematocrit in 48 h) was a secondary outcome. We measured edema (thigh, leg and ankle circumference) before and on the third postoperative day. All underwent the same rehabilitation and were encouraged to walk on the same day of surgery. For 10 days, participants received the IPCD, used 24 h/day on the operated leg from the end of surgery, or 40 mg of enoxaparin, starting 12 h after surgery. In this open, randomized trial (1:1), adults with no history of coagulation disorders, anticoagulant use, venous thromboembolism, liver or malignant diseases underwent TKA. We hypothesised that unilateral IPCD would cause the same level of edema and the same blood loss as enoxaparin. We compared the effects of enoxaparin versus unilateral portable IPCD after TKA on edema and blood loss. However, there is uncertainty about the need for the combination of both and whether a unilateral IPCD would alone affect other important clinical outcomes: edema and blood loss. Most studies in this context compare anticoagulants versus a combination of these drugs with an intermittent pneumatic compression device (IPCD). Pharmacological and mechanical thromboprophylaxis are frequently used together after total knee arthroplasty (TKA).
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