Graded compression stockings in elective orthopaedic surgery - An assessment of the in vivo performance of commercially available stockings in patients having hip and knee arthroplasty

We recruited 89 patients who had hip or knee replacements to assess the per formance of below-knee graded compression stockings, The pressure gradients generated by the stockings were measured and all patients had venography o f the ipsilateral leg. We found that 98% of stockings failed to produce the "ideal' pressure gradi ent (+/- 20%) of 18, 14 and 8 mmMg from the ankle to the knee, while 54% pr oduced a 'reversed gradient' on at least one occasion during the course of the study, The overall rate of deep-venous thrombosis was 16.7%. Stockings which produced reversed gradients were associated with a significantly high er incidence of deep-venous thrombosis (p = 0.026) than those with the corr ect gradient: (25.6% v 6.1%). This suggests that the performance of graded compression stockings can he improved if reversed pressure gradients are de tected and prevented.