Total ankle arthroplasty in patients with inherited bleeding disorders

Kotela, Andrzej; Lorkowski, Jacek; Żbikowski, Piotr; Ambroziak, Paweł; Kucharzewski, Marek; Kotela, Ireneusz

doi:10.1111/hae.12673

Cited by 14 publications

(25 citation statements)

References 10 publications

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“…The role of broad preoperative patient education should be emphasized. This population requires extensive information about the ongoing debate on TAR vs. ankle arthrodesis as well as the increased risk of various complications, such as intra-articular and periarticular bleeding, anaemia, development of an inhibitor, delayed wound healing, superficial and deep periprosthetic infections, and implant loosening, which are considered to be the most serious adverse events complicating joint arthroplasty procedures in hemophiliacs [ 17 – 19 ]. In addition, most individuals undergoing TAR in this group of patients are young and thus may require further operations in the future, which they should be informed about.…”

Section: Discussionmentioning

confidence: 99%

“…In their group, the mean AOFAS score improved significantly, from 21.5 to 68.0 points, the VAS score decreased significantly from 7.6 to 1.9 points, and ROM increased from 23.2 to 25.0 degrees, but without statistical significance. In addition, Ajis et al [ 3 ] assessed 119 TARs of 3 different prosthetic designs performed in a non-hemophilic population and found no notable improvement in the ankle ROM at 6 months after total ankle arthroplasty. In our opinion, it is therefore appropriate to use such a postoperative rehabilitation program in which one of the basic techniques of intervention is used to improve the mobility of the treated joint.…”

Section: Discussionmentioning

confidence: 99%

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Perioperative Physiotherapy for Total Ankle Replacement in Patients with Inherited Bleeding Disorders: Outline of an Algorithm

Kotela

Wilk-Frańczuk

Jaczewska³

et al. 2017

Med Sci Monit

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The treatment of end-stage hemophilic arthropathy of the ankle joint remains a controversial problem, and total ankle replacement (TAR) is considered to be a valuable management option. Physiotherapy continues to be an extremely important part of TAR and has a tremendous impact on the outcomes of this procedure. Given the lack of data on the latter, this study details a protocol of perioperative physiotherapy in TAR in patients with inherited bleeding disorders (IBD).The protocol outlined in this paper was devised via consultations within an interdisciplinary group, the authors’ own experiences with TAR in hemophilic and non-hemophilic patients, previous reports on this issue in the literature, and patient opinions. Our working group followed the criteria of the International Classification of Functioning, Disability and Health.The algorithm includes 4 physiotherapy phases with specified time frames, aims, interventions, and examples of exercises for each phase. We emphasize the importance of preoperative rehabilitation, and recommend introducing intensive physiotherapy immediately after the surgery, with regard to the wound protection and avoiding full weight-bearing in the first weeks. The intensity of physiotherapy should be adjusted individually depending on individual patient progress.This study details a rehabilitation protocol for TAR in patients with IBDs, which can be equally applicable to clinicians and researchers. Further scientific studies are required to investigate the beneficial effect of different protocols as well as to clarify the effectiveness of various frequencies, durations, and intensities of selected interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Perioperative Physiotherapy for Total Ankle Replacement in Patients with Inherited Bleeding Disorders: Outline of an Algorithm

Kotela

Wilk-Frańczuk

Jaczewska³

et al. 2017

Med Sci Monit

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“…Osteoporosis is a civilization disease which is still challenging for contemporary medicine not only in terms of treatment but also prophylaxis. It is closely related to decreasing the quality of life and numerous complications resulting from BMD reduction, including fractures and accelerated progress of osteoarthritis [41, 42]. Osteoporotic lesions also occur in numerous articular pathologies, such as rheumatoid arthritis or hemophilic arthropathy [43–45].…”

Section: Conclusion and Future Perspectivesmentioning

confidence: 99%

Role of CX3CL1/CX3CR1 Signaling Axis Activity in Osteoporosis

Turczyn

Dobies-Krzesniak

Frasuńska

et al. 2019

Mediators of Inflammation

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Osteoporosis is a civilization disease which is still challenging for contemporary medicine in terms of treatment and prophylaxis. It results from excessive activation of the osteoclastic cell line and immune cells like macrophages and lymphocytes. Cell-to-cell inflammatory information transfer occurs via factors including cytokines which form a complex network of cell humoral correlation, called cytokine network. Recently conducted studies revealed the participation of CX3CL1 chemokine in the pathogenesis of osteoporosis. CX3CL1 and its receptor CX3CR1 present unique properties among over 50 described chemokines. Apart from its chemotactic activity, CX3CL1 is the only chemokine which may function as an adhesion molecule which facilitates easier penetration of immune system cells through the vascular endothelium to the area of inflammation. The present study, based on world literature review, sums and describes convincing evidences of a significant role of the CX3CL1/CX3CR1 axis in processes leading to bone mineral density (BMD) reduction. The CX3CL1/CX3CR1 axis plays a principal role in osteoclast maturation and binding them with immune cells to the surface of the bone tissue. It promotes the development of inflammation and production of many inflammatory cytokines near the bone surface (i.e., TNF-α, IL-1β, and IL-6). High concentrations of CX3CL1 in serum are directly proportional to increased concentrations of bone turnover and inflammatory factors in human blood serum (TRACP-5b, NTx, IL-1β, and IL-6). Regarding the fact that acting against the CX3CL1/CX3CR1 axis is a potential target of immune treatment in osteoporosis, the number of available papers tackling the topic is certainly insufficient. Therefore, it seems justified to continue research which would precisely determine its role in the metabolism of the bone tissue as one of the most promising targets in osteoporosis therapy.

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“…All available clinical studies reporting TAR outcomes in patients with bleeding disorders have demonstrated significant pain relief [65][66][67][68][69][70][71][72][76][77][78]80,81]. Most studies reported improved functionality, including increased ankle range of motion, postoperatively [65][66][67][68]72,75,76,79,80,82]. However, the observed increase in range of motion was overall very low with an average of <10° (Table 3).…”

Section: Total Ankle Replacementmentioning

confidence: 99%