Ankle arthropathy in the haemophilic patient: a description of a novel ankle arthrodesis technique

Mann, H. A.; Biring, G.; Choudhury, Mahbuba; Lee, C. A.; Goddard, N J

doi:10.1111/j.1365-2516.2008.01651.x

Cited by 22 publications

(12 citation statements)

References 15 publications

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“…Mann et al . , described the results of eight ankle fusions with a mean follow‐up of nearly 4 years. The authors reported excellent pain relief and improvements in function, with one patient requiring screw removal due to pain.…”

Section: Discussionmentioning

confidence: 99%

“…While ankle fusion has long been accepted as the procedure of choice for end‐stage arthropathy in the haemophilic patient, there is a paucity of studies evaluating its long‐term outcome. Most available studies have small sample sizes with short follow‐up times.…”

Section: Discussionmentioning

confidence: 99%

“…Although there is increased interest in total ankle replacement in the haemophilic population [7][8][9], ankle fusion remains the procedure of choice for advanced ankle arthropathy in haemophilia patients [2,4,[10][11][12][13][14]. However, despite its widespread use and acceptance in this population, there have been few studies evaluating its long-term efficacy.…”

Section: Introductionmentioning

confidence: 99%

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Ankle fusion in patients with haemophilia

et al. 2013

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Ankle fusion in patients with haemophilia is a well-accepted treatment for end-stage arthropathy. However, current published outcome data are based on small sample sizes and generally short-term follow-up. The aim of this study was to evaluate the long-term results of ankle fusion in a large group of haemophilic patients treated at a single institution. The results of 57 ankle fusions performed on 45 patients between 1971 and 2010 were reviewed retrospectively. Data were gathered for type and severity of haemophilia, HIV status, fixation technique, postoperative complications and requirement of additional surgeries. A modified American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score was calculated for 20 ankles available for follow-up. Patients were followed for a mean of 6.6 years. There were no intra-operative or immediate postoperative complications related to fusion of the ankle. The overall non-union rate was 10.4% for tibio-talar fusion and 8.3% for sub-talar fusion. This rate was reduced to 3.7% and 5.6%, respectively, after the introduction of newer surgical techniques in 1995. None of these non-unions required revision surgery. The modified AOFAS scale demonstrated that 75% had no pain in the operated ankle a mean of 7.2 years following surgery. The remaining 25% scored their average pain as 3 of 10. The functional portion of the score suggested that patients have good alignment, minimal activity limitations or gait abnormalities, and can walk long distances. We conclude that ankle fusion successfully relieves pain and provides a good functional outcome. It is an appropriate treatment for end-stage haemophilic arthropathy of the ankle.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ankle fusion in patients with haemophilia

et al. 2013

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“…Rodriguez-Merchan [27] reported about good short-term results in two patients underwent tibiotalar fusion. Only recently Mann et al [31] described a novel ankle arthrodesis technique using medial approach to the ankle, bone graft and compression with staples. This technique was used in seven patients with haemophilia A and in one patient with haemophilia B, all patients were satisfied at the latest follow-up of 4 years.…”

Section: Discussionmentioning

confidence: 99%

Haemophilic arthropathy of the ankle treated by total ankle replacement: a case series

et al. 2010

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The standard treatment for end-stage osteoarthritis of the ankle joint in haemophilic patients has been fusion of the ankle joint. Total ankle replacement is still controversial as a treatment option. The objective of this prospective study was to evaluate the mid-term outcome in patients treated with total ankle replacement using an unconstrained three-component ankle implant. Ten haemophilic ankles in eight patients (mean age: 43.2 years, range 26.7-57.5) treated with total ankle replacement were followed up for a minimum of 2.7 years (mean: 5.6, range 2.7-7.6). The outcome was measured with clinical and radiological evaluations. There were no intra- or peri-operative complications. The AOFAS-hindfoot-score increased from 38 (range 8-57) preoperatively to 81 (range 69-95) postoperatively. All patients were satisfied with the results. Four patients became pain free; in the whole patient cohort pain level decreased from 7.1 (range 4-9) preoperatively to 0.8 (range 0-3) postoperatively. All categories of SF-36 score showed significant improvements in quality of life. In one patient, open ankle arthrolysis was performed because of painful arthrofibrosis. For patients with haemophilic osteoarthritis of the ankle joint, total ankle replacement is a valuable alternative treatment to ankle fusion.

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“…However, VWD is a known reason for haemophilic arthropathy. ankle arthrodesis, TAR) [15,29,[55][56][57][58][59][60][61][62][63]. Sood et al [8] described similarity in joint function limitations in patients with Type 3 VWD and moderate haemophilia A.…”

Section: Discussionmentioning

confidence: 99%

Total ankle replacement in patients with von Willebrand disease: mid‐term results of 18 procedures

et al. 2015

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von Willebrand disease (VWD) is a recognized cause of secondary ankle osteoarthritis (OA). Few studies have examined orthopaedic complications and outcomes in VWD patients treated for end-stage ankle OA with total ankle replacement (TAR). To determine the clinical presentation, intraoperative and postoperative complications and evaluate the mid-term outcome in VWD patients treated with TAR. Eighteen patients with VWD with mean age 47.3 years (range = 34.0-68.7) were treated for end-stage ankle OA with TAR. The mean duration of follow-up was 7.5 years (range = 2.9-13.2). Intraoperative and perioperative complications were recorded. Component stability was assessed with weight-bearing radiographs. Clinical evaluation included range of motion (ROM) tests using a goniometer and under fluoroscopy using a lateral view. Clinical outcomes were analysed by a visual analogue scale, the American Orthopaedic Foot and Ankle Society hindfoot score and Short Form (36) Health Survey (SF-36) health survey. One patient sustained an intraoperative medial malleolar fracture. In two patients delayed wound healing was observed. Two secondary major surgeries were performed. Pain level decreased from 8.2 ± 0.9 (range = 7-10) preoperatively to 1.1 ± 1.2 (range = 0-4) postoperatively. Significant functional improvement including ROM was observed. All categories of SF-36 score showed significant improvement in quality of life. Mid-term results of TAR in patients with VWD are encouraging. The total rate of intraoperative and postoperative complications was 33.3%. However, longer term outcomes are necessary to fully understand the clinical benefit of TAR in patients with VWD.

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Ankle arthropathy in the haemophilic patient: a description of a novel ankle arthrodesis technique

Cited by 22 publications

References 15 publications

Ankle fusion in patients with haemophilia

Ankle fusion in patients with haemophilia

Haemophilic arthropathy of the ankle treated by total ankle replacement: a case series

Total ankle replacement in patients with von Willebrand disease: mid‐term results of 18 procedures

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