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Hemophilic ankle arthropathy

W J Ribbans1, A M Phillips

  • 1Haemophilia Unit, Royal Free Hospital, Hampstead, London, England.

Clinical Orthopaedics and Related Research
|July 1, 1996
PubMed
Summary
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Ankle arthropathy significantly impacts hemophilic patients, causing progressive hindfoot decline. Prophylactic treatment is crucial for preserving ankle function and preventing disability.

Area of Science:

  • Orthopedics
  • Hematology
  • Rheumatology

Background:

  • Ankle arthropathy is a common cause of disability in hemophilic patients.
  • Bleeding into the ankle typically begins in the second decade, leading to progressive damage, pain, stiffness, and deformity.
  • Despite medical advancements, the decline in hindfoot function over four decades remains consistent.

Purpose of the Study:

  • To review the long-term progression of ankle arthropathy in hemophilic patients.
  • To develop an improved clinical and radiologic scoring system for assessing ankle damage.
  • To emphasize the importance of prophylactic treatment in managing hemophilic ankle arthropathy.

Main Methods:

  • Review of hemophilic patient cohorts at the Royal Free Hospital over 40 years.

Related Experiment Videos

  • Development of a combined clinical and radiologic scoring system incorporating ankle-specific features (talar tilt, tibial osteophytes, talar dome flattening).
  • Correlation of the new scoring system with objective measures like treadmill walking.

    • Main Results:

    • No evidence of change in the pattern of hindfoot function decline despite medical improvements.
    • The new scoring system shows better correlation with objective measures than traditional systems.
    • Prophylactic treatment is essential for arresting functional decline; surgical interventions are infrequent.

    Conclusions:

    • Ankle arthropathy progression in hemophilic patients is a persistent issue.
    • A novel scoring system aids in better assessment of ankle joint damage.
    • Prophylactic treatment is the cornerstone of managing hemophilic ankle arthropathy, with surgery reserved for severe cases.