ArticleHaemophilia : the official journal of the World Federation of Hemophilia2022
Ankle joint distraction is a promising alternative treatment for patients with severe haemophilic ankle arthropathy.
Article in Haemophilia : the official journal of the World Federation of Hemophilia, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed, 7 citations in OpenAlex.
- Ankle joint distraction is a promising alternative treatment for patients with severe haemophilic ankle arthropathy.Haemophilia : the official journal of the World Federation of Hemophilia · 2022Article
- Activities of Daily Living and Quality of Life After Orthopaedic Surgery for Haemophilic Arthropathy: A Scoping Review.Haemophilia : the official journal of the World Federation of HemophiliaArticle
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10 authors at 1 institution in 1 country.
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Abstract
introductionHaemophilic ankle arthropathy (HAA) causes major morbidity. When conservative treatment fails, major surgical interventions are indicated. An alternative treatment to maintain joint mobility and postpone these interventions is desired.
aimTo gather prospective data on clinical/structural changes after ankle joint distraction (AJD) in HAA.
methodsThis study includes patients with severe HAA insufficiently responding to conservative treatment. AJD was performed during 8-10 weeks by use of an external frame. Questionnaires, physical examination and radiology were used to evaluate pain, function and structural changes before and 6, 12, 24 and 36 months after distraction. Mixed effect models were used for analysis.
resultsThis study includes eight cases (21-53 years). The fixed effects estimates of the visual analogue score (0-10) improved from 7.5 at baseline to 3.4 (p = .023) 3 years after distraction. The Haemophilia Activities List (HAL, 0-100) for basic/complex lower extremities functions improved from respectively 29.6 and 31.5 to 54.3 (p = .015) and 50.7 (p = .031). Joint mobility was maintained. Magnetic resonance imaging (MRI) showed thickened cartilage and reduced bone marrow oedema and subchondral cysts. Pin tract infections (n = 6) were effectively treated and no adverse bleeding events occurred. At 3-year follow-up, in none of the patients the originally indicated arthrodesis was performed.
conclusionThis first prospective study showed that AJD in HAA results in decreased pain, improved function and decreased arthropathy-related MRI findings in the majority of patients for prolonged time. Although the study population is small and follow-up is relatively short, AJD may be promising to postpone invalidating interventions and might be a breakthrough treatment.
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