{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T18:20:39Z","timestamp":1761157239867,"version":"3.40.5"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T00:00:00Z","timestamp":1633651200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ankle arthropathy is a frequent complication of haemophilia, reducing the patients\u2019 quality of life. Despite intensive conservative therapy, end\u2010stage arthropathy requires surgical treatment, either by ankle fusion (AF) or total ankle replacement (TAR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eleven consecutive AFs were performed in nine patients and 11 TARs were implemented in 10 patients. Outcomes were assessed clinically by AOFAS score and radiologically by the Pettersson and Gilbert scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age of the patients in these groups were 35.7 years and 49.4 years, respectively. Of the 11 ankles that underwent fusion, 10 showed bony consolidation not later than 12\u00a0weeks after surgery, whereas one still showed non\u2010union after 6\u00a0months. VAS pain scores decreased significantly in both groups. Mean AOFAS scores also improved significantly, from 28.1 before to 80.3 after AF and from 21.5 before to 68.0 after ankle replacement. No perioperative complications were observed in either group. Late deep infection was observed in two patients that underwent TAR, which required removal of the implant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our data indicate that both AF and TAR result in significantly reduced pain in patients with haemophilia with end\u2010stage haemophilic arthropathy. While TAR is associated with a higher risk of deep infection and minimal persistent pain, it preserves the pre\u2010operative range of motion. AF on the other hand is associated with the risk of non\u2010union and a longer post\u2010operative recovery period but results in greater pain reduction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hae.14429","type":"journal-article","created":{"date-parts":[[2021,10,10]],"date-time":"2021-10-10T13:04:04Z","timestamp":1633871044000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Clinical and patient reported outcome in total ankle replacement compared to ankle fusion in end\u2010stage haemophilic arthropathy"],"prefix":"10.1111","volume":"27","author":[{"given":"Haider","family":"Mussawy","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery University Medical Centre Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Kehrer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, University of Bonn  Bonn Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9","family":"Strahl","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University Medical Centre Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Rolvien","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University Medical Centre Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Hubert","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University Medical Centre Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank Timo","family":"Beil","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University Medical Centre Hamburg\u2010Eppendorf  Hamburg 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