Document Type : CURRENT CONCEPTS REVIEW
Department of Orthopaedic Surgery, La Paz University Hospital- IdiPaz, Paseo de la Castellana 261, 28046-Madrid, Spain
There are several manners to take care of the hemophilic ankle in the initial phases of degeneration of the articular
cartilage, in the event that hematologic prophylaxis is unsuccessful in accomplishing no bleeds. Some of these are
nonoperative, with which management must start. These are Physical and Rehabilitation Medicine protocols and the
utilization of orthoses (patellar tendon bearing). When these are unsuccessful, more aggressive types of treatment
can be utilized, such as radiosynovectomy and some surgical operations (open or arthroscopic removal of anterior
osteophyte of the distal part of the tibia, arthroscopic ankle debridement). Nonetheless, in the late phases of degeneration
of the articular cartilage (advanced arthropathy), the solely options are surgical: ankle fusion or total ankle arthroplasty.
The review of the literature has shown that the percentage of consolidation is between 90% and 100%, and that the
percentage of postoperative infection is between 0% and 10%%. When the Ilizarov external fixator is utilized for ankle
fusion, the percentage of pin tract infection is around 14%. Ankle fusion is a secure surgical technique that meliorates
articular pain and improves the quality of life of hemophilic patients.
Level of evidence: III