Inclusion Criteria:  adult patients (age 40-85) first elective total hip replacement (THR) or first or second (opposite knee) elective total knee replacement (TKA speak English expected to have a hospital stay of two days or less discharge to home from hospital (not a rehabilitation facility) must be able to perform self-care BMI between 18 and 39 calf circumference between 11 and 24.5 inches  Exclusion Criteria:  partial joint replacement, TJR revisions, emergency surgeries calf deformities that would not allow proper fit for external compression device non-ambulatory clinically malnourished or frail/deconditioned vulnerable patients (pregnant women, prisoners, homeless and cognitively impaired) do not speak English