Ankle arthrodesis and total ankle replacement in patients with congenital bleeding disorders suffering from severe ankle arthropathy.

IF 2.3 4区医学 Q2 HEMATOLOGY Expert Review of Hematology Pub Date : 2024-01-01 Epub Date: 2023-12-27 DOI:10.1080/17474086.2023.2299301

E Carlos Rodriguez-Merchan

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Abstract

Introduction: In patients with congenital bleeding disorders suffering from severe ankle arthropathy, when conservative treatment and joint-preserving surgical techniques fail, there are two possible non-joint-preserving options: ankle arthrodesis (AA) and total ankle replacement (TAR).

Areas covered: The scope and aim of this article was to analyze the current role of AA and TAR in patients with congenital bleeding disorders suffering from severe ankle arthropathy.

Expert opinion: In patients with congenital bleeding disorders, both TAR and AA provide good results, mainly in terms of pain relief, although they are not exempt from complications (between 0% and 33% in TAR and between 5% and 23.5% in AA). The current controversy about which of the two surgical techniques, TAR or AA, gives better results, the current literature is not able to resolve it in patients with congenital bleeding disorders. While this question is being answered, my opinion regarding patients with congenital bleeding disorders is that the age of the patient must be taken into account. Given known prosthetic survival rates, the older the patient, the more we might be inclined to indicate TAR. Conversely, AA may be more appropriate for relatively young patients.

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严重踝关节病的先天性出血性疾病患者的踝关节固定术和全踝关节置换术。

导言：对于患有严重踝关节病的先天性出血性疾病患者，当保守治疗和保留关节的外科技术失败时，有两种可能的非保留关节选择：踝关节固定术（AA）和全踝关节置换术（TAR）：本文的范围和目的是分析AA和TAR目前在患有严重踝关节病的先天性出血性疾病患者中的作用：专家观点：对于先天性出血性疾病患者，TAR和AA都能提供良好的治疗效果，主要是在缓解疼痛方面，但它们也不能避免并发症（TAR的并发症发生率在0%至33%之间，AA的并发症发生率在5%至23.5%之间）。目前关于 TAR 和 AA 两种手术技术哪种效果更好的争议，在先天性出血性疾病患者中，目前的文献还无法解决。在回答这个问题的同时，我对先天性出血性疾病患者的看法是，必须考虑患者的年龄。考虑到已知的假体存活率，患者年龄越大，我们就越倾向于使用TAR。相反，AA可能更适合相对年轻的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Hematology HEMATOLOGY-

CiteScore

4.70

自引率

3.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Advanced molecular research techniques have transformed hematology in recent years. With improved understanding of hematologic diseases, we now have the opportunity to research and evaluate new biological therapies, new drugs and drug combinations, new treatment schedules and novel approaches including stem cell transplantation. We can also expect proteomics, molecular genetics and biomarker research to facilitate new diagnostic approaches and the identification of appropriate therapies. Further advances in our knowledge regarding the formation and function of blood cells and blood-forming tissues should ensue, and it will be a major challenge for hematologists to adopt these new paradigms and develop integrated strategies to define the best possible patient care. Expert Review of Hematology (1747-4086) puts these advances in context and explores how they will translate directly into clinical practice.