Ankle arthrodesis for end-stage haemophilic ankle arthropathy using a Ilizarov method

Only a few studies in the literature have reported on the outcome of ankle arthrodesis in haemophilia patients, and the optimal surgery technique for end-stage haemophilic ankle arthropathy remains controversial. The purpose of this study was to evaluate the results of ankle arthrodesis using the Ilizarov method in treating end-stage haemophilic ankle arthropathy.

Fourteen haemophilia patients with end-stage ankle arthropathy who underwent ankle arthrodesis using the Ilizarov method from December 2013 to May 2018 were enrolled in this study. The hospital day, fusion rate, complications, and functional outcomes were recorded and analyzed. Functional outcomes were evaluated according to the pre-operative and final follow-up of the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind foot score, visual analog scale (VAS), and Medical Outcomes Short Form 12-item questionnaire score (SF-12) .

All patients achieved bony fusion as confirmed by post-operative radiographs. The average time to fusion was 12.9 weeks (range, 10-17 weeks). Superficial pin track infection was observed in two patients, and subtalar arthritis was found in one patient. The mean AOFAS ankle-hind foot score, VAS score, physical component summary (PCS), and mental component summary (MCS) at final follow-up were significantly improved compared with the pre-operative data. All patients were satisfied with the surgery.

Ankle arthrodesis using the Ilizarov method is a minimally invasive, effective, and safe surgical method and can be a viable option for hemophilia patients with end-stage ankle arthropathy.