Ankle surgery in haemophilia with special emphasis on arthroscopic debridement

Rodríguez-Merchán, E. Carlos

doi:10.1111/j.1365-2516.2008.01820.x

Cited by 36 publications

(37 citation statements)

References 20 publications

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“…Most studies have reported decreased haemarthrosis and improved clinical outcomes postoperatively. However, the study reported by Rodriguez‐Merchan involving patients aged <20 years and another study showed that arthroscopic synovectomy only temporarily improved symptoms and was associated with postoperative neurological complications and infections …”

Section: Discussionmentioning

confidence: 96%

Anterior osteophyte resection of the ankle joint to increase range of motion in haemophilic ankle arthropathy

2019

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Introduction Haemophilic ankle arthropathy may cause joint bleeding, pain, stiffness, erosion and progressive motion limitations, including a decreased range of motion (ROM) secondary to anterior osteophyte impingement. Aim The purpose of this study was to investigate changes in the ROM and symptoms after synovectomy and anterior osteophyte resection for haemophilic ankle arthropathy. Methods We retrospectively reviewed 41 ankles in 35 patients with haemophilic arthropathy who underwent arthroscopic and/or open synovectomy. The mean follow‐up period was 59.5 months. Indications for the procedure included a lack of improvement with conservative management, and the presence of haemarthrosis and arthralgia. We assessed radiographic images, ankle joint range of motion, the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle‐Hindfoot score and patients’ subjective satisfaction preoperatively and at the last follow‐up. Results Arthroscopic synovectomy was performed in 32 ankles, open synovectomy in 6, and arthroscopic synovectomy with additional mini‐open debridement in 3. Ankle dorsiflexion improved from a mean of 2.7° preoperatively to a mean of 7.5° at the final follow‐up (P = 0.003), whereas plantar flexion improved from a mean of 30.7° preoperatively to a mean of 32.7° at the final follow‐up (P = 0.276). The AOFAS score improved from 62.2 preoperatively to 79.1 at the final follow‐up (P < 0.001). Patient satisfaction was “excellent” in 11 ankles, “good” in 22, “fair” in 3 and “poor” in 5. Conclusion Arthroscopic and/or open synovectomy with anterior osteophyte resection and early rehabilitation in adolescents and adults with haemophilic ankle arthropathy showed improved ankle dorsiflexion and AOFAS scores.

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Section: Discussionmentioning

confidence: 96%

Anterior osteophyte resection of the ankle joint to increase range of motion in haemophilic ankle arthropathy

2019

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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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“…16 Treatment recommendations for patients with chronic synovitis and arthropathy should be made after careful consideration of all potential options. Surgical intervention is indicated when conservative treatment fails.…”

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confidence: 99%