Short-term and mid-term outcome of total ankle replacement in haemophilic patients

• Report of the experience on the use of 32 prostheses in haemophilic patients.
• Gain in the range of motion during dorsiflexion is important for gait cycle.
• 7 patients were HIV positive, but no infections of the ankle joint in our series.
• Limitations: retrospective study, presenting only a medium-term review.

BackgroundAnkle arthropathy is very frequent in haemophilic patients. Prostheses are valuable alternatives to arthrodesis in non-haemophilic patients. We report the experience of a single centre in France on the use of prostheses in haemophilic patients.MethodsRetrospective study of 21 patients with haemarthropathy who underwent ankle arthroplasty (32 ankles), with additional surgery, if needed, from July 2002 to September 2009 (mean follow-up 4.4 ± 1.7 years). The American Orthopaedic Foot and Ankle Society (AOFAS) ankle–hindfoot scale was used to evaluate pain, function, ankle mobility and alignment.ResultsThe overall AOFAS score improved from 40.2 ± 19.4 (pre-surgery) to 85.3 ± 11.4 (post-surgery). The function score increased from 23.6 ± 7.7 to 35.9 ± 6.7 and dorsiflexion from 0.3° ± 5.0° to 10.3° ± 4.4°. Two patients underwent further ankle arthrodesis. On X-ray, both tibial and talar components were stable and correctly placed in all ankles. Alignment was good.ConclusionAnkle arthroplasty is a promising alternative to arthrodesis in haemophilic patients.