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Total ankle replacement seen as viable alternative for patients with hemophilic ankle arthropathy
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SEATTLE — Total ankle replacement is a viable treatment for patients with advanced hemophilic ankle arthropathy and shows favorable outcomes at midterm and long-term follow-up, according to a speaker at the American Orthopaedic Foot and Ankle Society Annual Meeting. However, based on radiographic results, the speaker noted patients may later require secondary surgery.
“All follow-up radiographs reveal signs of component loosening or periprosthetic lucency,” Franziska Eckers, MD, said during her presentation. “Considering this, as well as this study population’s young age and specific risk factors, the need for revision may arise for the majority of these patients.”
Eckers and colleagues evaluated 17 total ankle replacements performed between 1998 and 2012 for patients with hemophilic arthropathy. The mean age of patients was 43 years and the mean follow-up was 9.3 years. Kaplan-Meier analysis was used to estimate implant survival rate. Investigators assessed outcomes of 12 total ankle replacements after 9.6 years. To evaluate outcomes, investigators used satisfaction and pain sales, the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score and SF-36.
Results showed that at an average of 7.5 years, three patients underwent total ankle replacement removal secondary to loosening. At 5 years, 10 years and 15 years, estimated implant survival was 94%, 85% and 70%, respectively, and investigators noted the mean estimated implant survival was 14.77 years.
Patients had a mean level of satisfaction of 76% and scored their pain as a 2 out of 10 on the VAS. Investigators found a significant increase for range of motion and SF-36 summary scores were comparable to those of a matched standard population. On average, the AOFAS hindfoot score was 81/100. – by Monica Jaramillo
Reference:
Eckers F, et al. Mid- to long-term results of total ankle replacement in patients with hemophilic arthropathy: A 10-year follow-up. Presented at: American Orthopaedic Foot and Ankle Society Annual Meeting; July 12-15, 2017; Seattle.
Disclosure: Eckers reports no relevant financial disclosures.