Title:Total Ankle Replacement in Hemophilia
Volume: 20
Issue: 2
Author(s): Emerito C. Rodriguez-Merchan*
Affiliation:
- Department of Orthopedic Surgery, La Paz University Hospital, Madrid,Spain
Keywords:
Hemophilia, hemophilic arthropathy, ankle, total ankle replacement, hemarthrosis, rheumatoid arthritis.
Abstract:
Introduction: Severe ankle hemophilic arthropathy can be a calamitous sign of severe
hemophilia with important inferences for activities of daily living.
Aims: To summarize the contemporary, accessible information on Total Ankle Replacement (TAR)
for ankle hemophilic arthropathy.
Methods: A search of Cochrane Library and PubMed (MEDLINE) regarding the role of TAR in
ankle hemophilic arthropathy.
Results: The insufficient information regarding the results of TAR for hemophilic arthropathy is
confined to scanty case series and case reports. An evaluation of the accessible literature reveals
encouraging but inconstant outcomes. The reported rate of adverse events is 33%. The reported
anticipated survival of TAR is 94% at 5 years, 85% at 10 years and 70% at 15 years.
Conclusion: Whereas people with advanced hemophilic arthropathy of the ankle are prone to ameliorate
pain and range of motion following TAR, there is deficient knowledge to regularly recommend
its use. Adverse events and infection percentages are disturbing. Moreover, the lack of survival
analysis knowledge makes it difficult to assess the benefit to people with hemophilia. TAR is a
demanding surgical procedure and its survival is not comparable to that after hip or knee replacement.
