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Published on: January 24, 2018
Comparison of total ankle replacement and ankle arthrodesis in patients with haemophilia using gait analysis: two
Marc Dauty1, Raphael Gross2, Fabien Leboeuf3
1CHU Nantes, Pôle de MPR, Hôpital Saint Jacques, 85 rue Saint Jacques, 44093, Nantes Cedex 01, France. marc.dauty@chu-nantes.fr.
Background:
Severe hemophilia is an inherited, lifelong bleeding disorder characterized by spontaneous bleeding, which results in painful joint deformities. Currently two surgical treatments are available to treat haemophilia-related ankle joint destruction: ankle arthrodesis and total ankle replacement. The aim of the present study was to compare these two surgical procedures in haemophiliac subjects.
Case Presentation:
Kinematic and dynamic parameters were quantified using a three-dimensional gait-analysis system in two similar clinical cases. In Caucasian case 1, ankle arthrodesis was chosen because of a kinematic ankle flexion defect and lack of dynamic power regeneration. The defect in energy absorption was compensated for by the contralateral side. Total ankle replacement in Caucasian case 2 allowed sparing the ipsilateral knee (maximum 0.27 preoperatively vs. 0.71 W/kg postoperatively) and hip joints powers (maximum 0.43 preoperatively vs. 1.25 W/kg postoperatively) because of the small ankle dorsiflexion motion.
Conclusions:
Total ankle replacement is recommended for haemophiliac patients who present with a preserved ankle range of motion.
