Open synovectomy of the ankle joint in young haemophiliacs: mid‐term to long‐ term results of a single‐centre series of 32 procedures

Mingo-Robinet, J.; Odent, Thierry; Elie, Caroline; Torchet, M. F.; Glorion, Christophe; Padovani, Jean Paul; Rothschild, Chantal

doi:10.1111/hae.12704

Cited by 15 publications

(19 citation statements)

References 15 publications

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“…For example, in Italy the median life expectancy of haemophiliacs increased from 62 years between 1990 and 1999 to 71 years during 2000–2007 . Early surgical intervention is also important in young haemophiliacs for slowing disease progression and preventing lasting joint damage . Individuals with severe haemophilia A (FVIII <1% of normal) require intensified FVIII replacement during surgery, as well as during the immediate postoperative recovery period until wound healing is complete (>10 days in major surgery) .…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of pegylated full‐length recombinant factor VIII with extended half‐life for perioperative haemostasis in haemophilia A patients

Brand¹,

Gruppo

Wynn

et al. 2016

Haemophilia

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Introduction: BAX 855 is a pegylated full-length recombinant factor VIII (rFVIII) with an extended half-life, built on a licensed rFVIII (ADVATE â ). BAX 855 demonstrated efficacy and safety in prophylaxis and the treatment of bleeding episodes in previously treated patients (PTPs) with severe haemophilia A. Aim: This phase 3 surgery study evaluates the haemostatic efficacy and safety of BAX 855 for perioperative haemostasis in PTPs with severe haemophilia A undergoing surgery. Methods: Elective procedures were prospectively classified as major or minor. The dose and frequency of BAX 855 administered perioperatively were to be guided by each patient's pharmacokinetic profile for major procedures or BAX 855 incremental recovery for minor procedures. Haemostatic efficacy was evaluated using a predefined scale. Blood loss was compared to the expected average and maximum blood loss predicted preoperatively. Results: A total of 15 male patients (aged 19-52 years) underwent 15 procedures (11 major and four minor). The overall intra-and perioperative haemostatic efficacy of BAX 855 was 'excellent' in all 15 subjects (100%). Postoperatively, evaluated at postoperative Day 1, all treatments were 'excellent' except for one minor (dental) procedure which was rated 'good'. No related adverse events, allergic reactions, thrombotic events, nor signs of immunogenicity in terms of induction of binding antibodies to FVIII, PEG or PEG-VIII, or FVIII inhibitors were observed. Conclusion: These results demonstrate that BAX 855 is safe and haemostatically effective in patients with severe haemophilia A undergoing surgery.

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Section: Introductionmentioning

confidence: 99%

Efficacy and safety of pegylated full‐length recombinant factor VIII with extended half‐life for perioperative haemostasis in haemophilia A patients

Brand¹,

Gruppo

Wynn

et al. 2016

Haemophilia

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“…Previous studies have reported the use of open synovectomy for haemophilic ankle arthropathy; however, only a small number of patients were investigated . Greene reported the results of open synovectomy in five patients with severe haemophilic ankle arthropathy over a mean follow‐up of 5 years.…”

Section: Discussionmentioning

confidence: 99%

“…Pantopoulos et al reported a study involving six patients with a mean age of 29.6 years (range 8‐51 years) who underwent open synovectomy and a 32‐month follow‐up (range 12‐84 months). Mingo‐Robinet et al reported a study involving 21 patients aged <18 years with haemophilic ankle arthropathy with a mean follow‐up of 15.4 years. These reports show that open synovectomy was essentially restricted to the paediatric population.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the use of various conservative treatments, arthroscopic synovectomy and open synovectomy are definitive strategies to reduce recurrent bleeding and maintain joint function . Synovectomy itself does not inhibit arthropathic progression, but some authors report good results such as bleeding control and pain relief after synovectomy . The joint complex eventually ankyloses as a result of the gradual progression of haemarthropathic erosion, making ambulation difficult .…”

Section: Introductionmentioning

confidence: 99%

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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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“…The rate of intraarticular ankle bleedings requiring transfusion was reduced from an average of 3.4 per month (range, 0.3-5 per month) for the 6 months before the synovectomy to 0.1 per month (range, 0-0.2 per month) for the 12 months prior to the latest follow-up [38]. Mingo-Robinet et al [39] performed 32 open synovectomies in 21 patients with haemophilia with a mean age of 7.8 years. The mean follow-up in this study was 15.4 years, ranging from 5 to 26.2 years.…”

Section: Arthroscopic Debridementmentioning

confidence: 97%

Surgical procedures in patients with haemophilic arthropathy of the ankle

et al. 2016

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Open synovectomy of the ankle joint in young haemophiliacs: mid‐term to long‐ term results of a single‐centre series of 32 procedures

Cited by 15 publications

References 15 publications

Efficacy and safety of pegylated full‐length recombinant factor VIII with extended half‐life for perioperative haemostasis in haemophilia A patients

Efficacy and safety of pegylated full‐length recombinant factor VIII with extended half‐life for perioperative haemostasis in haemophilia A patients

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

Surgical procedures in patients with haemophilic arthropathy of the ankle

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