Surgical procedures in patients with haemophilic arthropathy of the ankle

Abstract

The current literature demonstrated that orthopaedic surgeries, with appropriate indication, in patients with haemophilic ankle arthropathy result in good postoperative results comparable to those observed in non-haemophiliacs. The surgical treatment should be performed in a setting with the ability to have multidisciplinary management, including expertise in haematology.

Arthroscopic debridement for advanced haemophilic ankle arthropathy

“…This cycle of bleeding and synovial hypertrophy leads to the development of a socalled target joint. 6,7 Severe joint destruction often develops in such joints. Before the ankle joint develops into a destructive joint, radioactive synovectomy is usually performed in European countries and in the USA; however, this treatment is not approved in Japan.…”

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

“…to consider additional surgical procedures including anterior osteophyte excision, Achilles tendon lengthening and posterior capsular release. 12 Most existing studies involve children and adolescents,…”

Commentary on the paper: “Hindfoot malalignment in adults with haemophilic ankle arthropathy: The importance of early detection and orthotic treatment”

“…In their study with 163 patients, 59.5% presented with a concomitant hindfoot deformity with valgus malalignment being the most common deformity . The treatment of haemophilic ankle arthropathy remains controversial and includes conservative and surgical treatment options. Surgical treatment options incorporating advanced arthropathy can be divided into two major groups – joint preserving and joint non‐preserving procedures .…”

“…The treatment of haemophilic ankle arthropathy remains controversial and includes conservative and surgical treatment options. Surgical treatment options incorporating advanced arthropathy can be divided into two major groups – joint preserving and joint non‐preserving procedures . A supramalleolar realignment surgery is often a good alternative to ankle arthrodesis or total ankle replacement for patients with a partially preserved tibiotalar joint …”

“…Surgical treatment options incorporating advanced arthropathy can be divided into two major groups -joint preserving and joint non-preserving procedures. 12 A supramalleolar realignment surgery is often a good alternative to ankle arthrodesis or total ankle replacement for patients with a partially preserved tibiotalar joint. 13,14 While the paper by De la Corte-Rodriguez et al 7 substantially contributed to a better understanding of the impact of hindfoot malalignment in patients with haemophilic ankle arthropathy, it also has some limitations.…”