Open Access, Peer-reviewed
pISSN 1226-2102
eISSN 2005-8918
    J Korean Orthop Assoc. 2014 Dec;49(6):463-470. Korean.
    Published online Dec 30, 2014.
    https://doi.org/10.4055/jkoa.2014.49.6.463
    Copyright © 2014 by The Korean Orthopaedic Association
    Original Article

    Short-Term Outcomes of Arthroscopic Synovectomy for Hemophilic Ankle Arthropathy

    Jae Hoon Lee, M.D., Duke-Whan Chung, M.D.,* and Dong Hee Kim, M.D.†
      • Department of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
      • *Department of Orthopedic Surgery, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea.
      • †Department of Orthopaedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
    • Correspondence to: Dong Hee Kim, M.D. Department of Orthopaedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 158 Paryong-ro, Masanhoewon-gu, Changwon 630-723, Korea. TEL: +82-55-290-6030, FAX: +82-55-290-6259, Email: dhkim1149@gmail.com
    Received March 04, 2014; Revised July 16, 2014; Accepted August 13, 2014.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Purpose

    This study reports on the results of clinical and radiological evaluation of arthroscopic synovectomy in hemophilic ankle arthropathy.

    Materials and Methods

    Between September 2006 and December 2008, arthroscopic synovectomy was performed on 35 ankle joints in 33 patients with hemophilic ankle arthropathy. The mean follow-up period was 30 months. The range of motion of joint and frequency of intra-articular bleeding and factor dose were evaluated for this study. American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hind foot score and subjective satisfaction were used for clinical assessment. Arnolf and Hilgartner classification was used for radiological assessment.

    Results

    The mean dorsiflexion and plantar flexion were 10.1°, 30.1°, respectively, at preoperation and 11.3°, 28.2°, respectively on the final day of follow-up with no significant difference in the range of motion. The mean frequency of hemarthrosis decreased significantly to 0.6 times per month postoperative (p<0.05). The mean amount of factor replacement decreased from 5,320 units/mo preoperative to 4,568 units/mo postoperative with no significance difference. AOFAS ankle and hind foot score was improved to 90 points postoperative with significance. On radiologic evaluation, 33 cases showed no significant changes, while two cases had progressed at the last follow-up.

    Conclusion

    Arthroscopic synovectomy for recurrent hemarthrosis in hemophilic ankle arthropathy is a useful method for familiar procedure, decreasing bleeding episodes and subjective satisfaction.

    Keywords
    ankle joint; hemophilia; arthroscopic synovetomy

    Figures

    Figure 1
    (A) Preoperative antero-posterior and lateral radiographs of a 19-year-old boy show that there is no joint space narrowing and cyst. (B) Arthroscopic finding shows moderate synovial hypertrophy and synovial band formation.

    Figure 2
    Serial outcomes of bleeding frequency.

    Figure 3
    (A) Preoperative antero-posterior and lateral radiographs of a 17-year-old boy showing narrow joint space and anterior beaking of the talus. (B) Arthroscopic finding shows synovial proliferation. We performed synovectomy. (C) Two years later, this radiographs show no evidence of disease progression.

    Tables

    Table 1
    Mean Amount of Factor Replacement, Mean Frequency of Hemarthrosis, and AOFAS Score before and after Arthroscopic Synovectomy

    Table 2
    Results of Previously Published Series of Open and Arthroscopic Ankle Synovectomy for Hemophilia

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    MeSH Terms
    Ankle Joint
    Ankle*
    Classification
    Follow-Up Studies
    Foot
    Hemarthrosis
    Hemophilia A
    Hemorrhage
    Humans
    Joints
    Range of Motion, Articular
    Metrics
    Share
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