Total ankle replacement in patients with haemophilia and virus infections - a safe alternative to ankle arthrodesis?

• Published in: Haemophilia : the official journal of the World Federation of Hemophilia 2014-09, Vol.20 (5), p.702-708
• Main Authors: Strauss, A. C., Goldmann, G., Wessling, M., Gravius, S., Müller, M. C., Wimmer, M. D., Wirtz, D. C., Oldenburg, J., Pennekamp, P. H.
• Format: Article
• Language: English
• Subjects: Adult; arthropathy; Arthroplasty, Replacement, Ankle; Coinfection; Follow-Up Studies; haemophilia; Hemophilia A - complications; Hepatitis C - complications; Hepatitis C virus; HIV Infections - complications; Human immunodeficiency virus; Humans; Male; Middle Aged; Osteoarthritis - surgery; Pain Measurement; Patient Satisfaction; Prosthesis Failure; Range of Motion, Articular; Retrospective Studies; total ankle replacement
• ISSN: 1351-8216; 1365-2516
• DOI: 10.1111/hae.12392

Summary Despite reliable results of ankle fusion for advanced haemophilic arthropathy, total ankle replacement (TAR) may be functionally advantageous. There is only very limited literature data available on TAR in patients with haemophilia. The objective of this study is to evaluate the short‐ and mid‐term results after TAR in patients with end‐stage haemophilic ankle arthropathy and concomitant virus infections. In a retrospective study, results after eleven TAR in 10 patients with severe (n = 8) and moderate (n = 2) haemophilia (mean age: 49 ± 7 years, range, 37–59) were evaluated at a mean follow‐up of 3.0 years (range, 1.2–5.4). Nine patients were positive for hepatitis C, five were HIV‐positive. Range of motion (ROM), AOFAS‐hindfoot‐score, pain status (visual analogue scale, VAS) as well as patient satisfaction were evaluated. In two cases deep prosthesis infection occurred leading to the removal of the implant. In the remaining eight patients the mean AOFAS score improved significantly from 21.5 to 68.0 points (P