{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T22:43:49Z","timestamp":1778539429745,"version":"3.51.4"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T00:00:00Z","timestamp":1702252800000},"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":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>In patients with haemophilia, repeated bleeding in large joints leads to chronic haemophilic arthropathy, a rare disease that can be managed surgically with ankle arthrodesis or with total ankle replacement (TAR). TAR has been reported to provide good surgical results in the medium\/long\u2010term and allow preservation of joint mobility but the medical therapeutic management of the patients has not been described.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To describe the medical therapeutic management of TAR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients with haemophilia A\/B, with haemophilic ankle arthropathy, and who underwent TAR between April 2006 and October 2019 were retrospectively included. Factor consumption, perioperative and early complications, volume of blood lost, and orthopaedic data were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 25 patients underwent 29 TAR (mean age was 44.7 years [range: 26\u201365]). In the 17 patients with HA without history of anti\u2010FVIII inhibitor, the mean\u00a0\u00b1\u00a0SD consumption the day of surgery was 116\u00a0\u00b1\u00a016 UI\/kg when clotting factors were administered by continuous infusion, 106\u00a0\u00b1\u00a013 UI\/kg when SHL factors were administered by bolus infusion, and 75\u00a0\u00b1\u00a022 UI\/kg when EHL factors were administered by bolus infusion. During hospitalisation, the mean factor cost was \u20ac38,073 (83.7% of the total cost of surgery). Mean blood loss was significantly lower in patients treated with tranexamic acid (164\u00a0mL, range: 40\u2013300) than in those not (300\u00a0mL, range: 70\u2013800; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.01). Six patients had haematoma. The 10\u2010year survival free of any prosthesis removal\/arthrodesis was estimated to be 92.2% (95% CI [83; 100]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The medical therapeutic management of TAR is complex, carried out by a multidisciplinary team but effective in avoiding the occurrence of complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hae.14909","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T20:19:14Z","timestamp":1702412354000},"page":"204-213","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A single\u2010centre experience of 29 total ankle replacement in haemophiliac patients: Therapeutic management, factor consumption and cost"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0044-9583","authenticated-orcid":false,"given":"Louise","family":"Favrelle","sequence":"first","affiliation":[{"name":"Hospices Civils de Lyon, Centre Hospitalier Lyon\u2010Sud, Service de pharmacie  Pierre\u2010B\u00e9nite France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean\u2010Baptiste","family":"Masson","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Centre Hospitalier Lyon\u2010Sud, Service de Chirurgie Orthop\u00e9dique et Traumatologique  Pierre\u2010B\u00e9nite France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"St\u00e9phanie","family":"Parat","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Centre Hospitalier Lyon\u2010Sud, Service de pharmacie  Pierre\u2010B\u00e9nite France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuelle","family":"Carre","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Centre Hospitalier Lyon\u2010Sud, Service de pharmacie  Pierre\u2010B\u00e9nite France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Fessy","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Centre Hospitalier Lyon\u2010Sud, Service de Chirurgie Orthop\u00e9dique et Traumatologique  Pierre\u2010B\u00e9nite France"},{"name":"Universit\u00e9 Lyon 1, IFSTTAR, LBMC UMR\u2010T 9406 \u2010 Laboratoire de Biom\u00e9canique et M\u00e9canique des Chocs  Bron France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Rioufol","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Centre Hospitalier Lyon\u2010Sud, Service de pharmacie  Pierre\u2010B\u00e9nite France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Lienhart","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Groupement Hospitalier Est, Service d'H\u00e9mostase clinique  Bron France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Val\u00e9rie","family":"Chamouard","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Groupement Hospitalier Est, Service d'H\u00e9mostase clinique  Bron France"},{"name":"Hospices Civils de Lyon, Groupement Hospitalier Est, Service de pharmacie  Bron France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean\u2010Luc","family":"Besse","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Centre Hospitalier Lyon\u2010Sud, Service de Chirurgie Orthop\u00e9dique et Traumatologique  Pierre\u2010B\u00e9nite France"},{"name":"Universit\u00e9 Lyon 1, IFSTTAR, LBMC UMR\u2010T 9406 \u2010 Laboratoire de Biom\u00e9canique et M\u00e9canique des Chocs  Bron France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,12,11]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Centre de R\u00e9f\u00e9rence H\u00e9mophilie et autres d\u00e9ficits constitutionnels en prot\u00e9ines de la coagulation. 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