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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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[Total ankle replacement in patients with bleeding disorders].

A Barg1, K Barg, M Wiewiorski

  • 1Orthopädische Universitätsklinik, Universität von Utah, 590 Wakara Way, 84108, Salt Lake City, UT, USA, alexej.barg@hsc.utah.edu.

Der Orthopade
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Summary

Total ankle replacement (TAR) offers encouraging mid-term results for patients with bleeding disorders, including hemophilia and von Willebrand disease. Experienced surgeons and a multidisciplinary approach are crucial for successful outcomes in this patient group.

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Area of Science:

  • Orthopedic Surgery
  • Hematology

Context:

  • Total ankle replacement (TAR) is a standard treatment for end-stage ankle osteoarthritis.
  • Limited data exists on TAR outcomes in patients with bleeding disorders.

Purpose:

  • To prospectively evaluate mid-term postoperative results of TAR in patients with bleeding disorders.

Summary:

  • 34 patients (14 hemophilia A, 20 VWD) underwent TAR. Mean follow-up was 6.3 years.
  • Significant improvements in pain relief (VAS), SF-36 quality of life, range of motion (ROM), and AOFAS hindfoot scores were observed.
  • Outcomes were comparable between hemophilia and VWD groups, but patients with bleeding disorders reported higher pain relief and lower ROM than controls.

Impact:

  • Encouraging mid-term outcomes support TAR in select patients with bleeding disorders.
  • Highlights the need for experienced surgeons and a multidisciplinary approach for optimal results.
  • Contributes valuable data to a sparsely documented area of orthopedic surgery.