Biomechanical markers and theoretical concepts related to haemophilic ankle and subtalar joint arthropathy: introducing the term ‘haemophilic tarsal pan‐arthropathy’

Abstract

In this context, the authors propose the use of 'haemophilic tarsal pan-arthropathy' (HTPA) which encompasses both tibiotalar and subtalar joints.

Reliability and clinical features associated with the IPSG MRI tibiotalar and subtalar joint scores in children, adolescents and young adults with haemophilia

“…Second, the IPSG MRI scale only assesses the TTJ, thus includes no qualitative assessment of the subtalar joint (STJ). Third, early‐stage STJ alterations are often well tolerated by patients who naturally adapt their gait, rendering them difficult to detect by clinical examination . Finally, new approaches in foot kinematics assessment using multisegment foot models now enable better comprehension of ankle and foot motion, though the degree of correlation between such measurements and medical imaging has as yet not been explored.…”

Hindfoot malalignment in adults with haemophilic ankle arthropathy: The importance of early detection and orthotic treatment

“…Other studies underscore the role played by the ST joint in the ankle-related problems suffered by PWH. 30 As it is to be expected, patients with haemophilic arthropathy of the ankle showed considerably higher Pettersson and HJHS 2.1 scores. These patients also experienced a higher degree of synovitis, as part of the physiopathological changes triggered by their haemarthroses.…”

“…This is certainly not a negligible figure. Other studies underscore the role played by the ST joint in the ankle‐related problems suffered by PWH . As it is to be expected, patients with haemophilic arthropathy of the ankle showed considerably higher Pettersson and HJHS 2.1 scores.…”

Assessment of passive musculoarticular ankle stiffness in children, adolescents and young adults with haemophilic ankle arthropathy

“…The major complications of haemophilia involve recurrent bleeding into the joints and muscles, eventually causing soft‐tissue fibrosis, cartilage damage and synovial hypertrophy, which gradually destroy the joints in relatively young patients . The ankle is the primary joint affected by haemophilic arthropathy, while particularly vulnerable even in children receiving the most optimal haemophilia treatment …”

“…1 The ankle is the primary joint affected by haemophilic arthropathy, while particularly vulnerable even in children receiving the most optimal haemophilia treatment. 2,3 Adequate prevention and optimal management of musculoskeletal complications in children with haemophilia thus require early detection of first signs of joint impairment in relatively asymptomatic patients. In recent years, there has been increasing interest in assessing structural and functional joint degradation by quantifying functional biomarkers, for better insight into the potential causes and consequences of joint bleedings and potential new conservative management strategies.…”