Abstract
Background Recurrent haemarthroses in patients with haemophilia commonly affect the ankles. It can result in haemophilic arthropathy and necessitate arthrodesis. The purpose of this report was to present the results of arthroscopic arthrodesis performed for this condition and to highlight some of the potential difficulties encountered as part of the surgical management. The operative technique is also described.
Method Between January 2001 and May 2004, eight male patients underwent nine arthroscopic arthrodeses. The mean age was 34 years (range 19–44). The patients were identified retrospectively from a surgical database and the radiographs and outpatient notes reviewed. Patients were also contacted to determine their level of satisfaction with the procedure.
Results The mean length of follow-up was 9 months (range 3–18). All patients had united both clinically and radiographically by the time of maximal follow-up and all were satisfied with the result. One patient had minor post-operative bleeding which settled spontaneously. No other significant complications were encountered. Bony cysts were observed in three patients pre-operatively and these all resolved following the attainment of union.
Conclusion Arthroscopic arthrodesis of the ankle is a safe and reliable treatment for haemophilic ankle arthropathy. The union rate is high, the complication rate is low, the risk of disease transmission from patient to staff is lessened and the post-operative rehabilitation regime, including allowing immediate weight bearing is less arduous than with traditional open procedures. Factor requirements are lessened and the length of stay is also reduced compared with open arthrodesis. Collaboration with a haematology unit is essential for a good result to be achieved.
Correspondence should be addressed to BOFSS, c/o Wrightington Wigan and Leigh NHS Trust, Hall Lane, Appley Bridge, Wigan, Lancashire WN7 9EP.
