Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain
10.22038/abjs.2025.85093.3876
Abstract
The objective of this paper is to carry out a review of the literature on the contemporary situation of total ankle replacement (TAR) in people with hemophilia (PWH). A search was performed in PubMed on December 29, 2024, utilizing the keywords “hemophilia” and “total ankle replacement.” To date solely 8 papers (136 TARs) in 103 PWH have been reported. All published series showed improvement in preoperative pain and function. However, the complication rate was 8.8% (intra-operative fractures of the medial malleolus, delayed wound healings, hematomas). Additional surgery is required in 5.1% of the TARs implanted (ankle arthrolysis due to painful arthrofibrosis, major surgeries, revision surgeries). The estimated 10-year survival free of any TAR removal or ankle fusion (AF) is 92.2%. Regarding the controversy AF or TAR in PWH, a recent systematic review and meta-analysis have found similar clinical results and rates of adverse events between TAR and AF in PWH. Level of evidence:III
Mortazavi SJ, Daneshpoor SMM, Shafiei SH. Total hip arthroplasty in patients with hemophilia: what do we know? Arch Bone Jt Surg. 2023;11(7):434-440. doi: 10.22038/ABJS.2023.58812.291.
Rodriguez-Merchan EC. Total hip arthroplasty in hemophilic patients: are their results similar to those of nonhemophilic patients? Arch Bone Jt Surg. 2024;12(5):357-360. doi: 10.22038/ABJS.2024.76984.3555.
Rodriguez-Merchan EC. Primary total knee arthroplasty in hemophilia and allied disorders: revision rates and their causes. Arch Bone Jt Surg. 2024;12(6):428-432. doi: 10.22038/ABJS.2024.76697.3544.
Rodriguez-Merchan EC, De la Corte-Rodriguez H, Antuña S, Gomez-Cardero P, Alvarez-Roman MT, Jimenez-Yuste V. Shoulder arthroplasty in hemophilia. Arch Bone Jt Surg. 2025;13(3):164-169. doi: 10.22038/ABJS.2024.80320.3667.
van der Heide HJ, Nováková I, de Waal Malefijt MC. The feasibility of total ankle prosthesis for severe arthropathy in haemophilia and prothrombin deficiency. Haemophilia. 2006;12(6):679-82. doi: 10.1111/j.1365-2516.2006.01350.x.
Barg A, Elsner A, Hefti D, Hintermann B. Haemophilic arthropathy of the ankle treated by total ankle replacement: a case series. Haemophilia. 2010;16(4):647-655. doi: 10.1111/j.1365-2516.2010.02221.x.
Strauss AC, Goldmann G, Wessling M, et al. Total ankle replacement in patients with haemophilia and virus infections--a safe alternative to ankle arthrodesis? Haemophilia. 2014;20(5):702-708. doi: 10.1111/hae.12392.
Asencio JG, Leonardi C, Biron-Andreani C, Schved JF. Short-term and mid-term outcome of total ankle replacement in haemophilic patients. Foot Ankle Surg. 2014;20(4):285-292. doi: 10.1016/j.fas.2014.08.004.
Barg K, Wiewiorski M, Anderson AE, et al.Total ankle replacement in patients with von Willebrand disease: mid-term results of 18 procedures. Haemophilia. 2015;21(5):e389-401. doi: 10.1111/hae.12561.
Preis M, Bailey T, Jacxsens M, Barg A. Total ankle replacement in patients with haemophilic arthropathy: primary arthroplasty and conversion of painful ankle arthrodesis to arthroplasty. Haemophilia. 2017;23(4):e301-e309. doi: 10.1111/hae.13200.
Eckers F, Bauer DE, Hingsammer A, et al. Mid- to long-term results of total ankle replacement in patients with haemophilic arthropathy: A 10-year follow-up. Haemophilia. 2018;24(2):307-315. doi: 10.1111/hae.13386.
Favrelle L, Masson JB, Parat S, et al. A single-centre experience of 29 total ankle replacements in haemophiliac patients: Therapeutic management, factor consumption and cost. Haemophilia. 2024;30(1):204-213. doi: 10.1111/hae.14909.
Dauty M, Gross R, Leboeuf F, Trossaert M. Comparison of total ankle replacement and ankle arthrodesis in patients with haemophilia using gait analysis: two case reports. BMC Res Notes. 2015;8:768. doi: 10.1186/s13104-015-1763-y.
Ahn J, Yoo MC, Seo J, Park M, Jeong BO. Comparison of total ankle arthroplasty and ankle arthrodesis in end-stage hemophilic arthropathy. Foot Ankle Int. 2020;41(8):937-944. doi: 10.1177/1071100720929002.
Mussawy H, Kehrer M, Strahl A, et al. Clinical and patient reported outcome in total ankle replacement compared to ankle fusion in end-stage haemophilic arthropathy. Haemophilia. 2021;27(6):e739-e746. doi: 10.1111/hae.14429.
Arthur RY, Mihas AK, Harris J, et al. Comparison of total ankle replacement and ankle arthrodesis for ankle arthropathy in patients with bleeding disorders: a systematic review and meta-analysis. Foot Ankle Int. 2023;44(7):645-655. doi: 10.1177/10711007231171123.
RODRIGUEZ-MERCHAN, E. C. (2025). Total Ankle Replacement in Hemophilia. The Archives of Bone and Joint Surgery, 13(10), 663-667. doi: 10.22038/abjs.2025.85093.3876
MLA
RODRIGUEZ-MERCHAN, E. C. . "Total Ankle Replacement in Hemophilia", The Archives of Bone and Joint Surgery, 13, 10, 2025, 663-667. doi: 10.22038/abjs.2025.85093.3876
HARVARD
RODRIGUEZ-MERCHAN, E. C. (2025). 'Total Ankle Replacement in Hemophilia', The Archives of Bone and Joint Surgery, 13(10), pp. 663-667. doi: 10.22038/abjs.2025.85093.3876
CHICAGO
E. C. RODRIGUEZ-MERCHAN, "Total Ankle Replacement in Hemophilia," The Archives of Bone and Joint Surgery, 13 10 (2025): 663-667, doi: 10.22038/abjs.2025.85093.3876
VANCOUVER
RODRIGUEZ-MERCHAN, E. C. Total Ankle Replacement in Hemophilia. The Archives of Bone and Joint Surgery, 2025; 13(10): 663-667. doi: 10.22038/abjs.2025.85093.3876