血友病患者全踝关节置换的短期和中期疗效
Short-term and mid-term outcome of total ankle replacement in haemophilic patients.
作者信息
Asencio J G, Leonardi C, Biron-Andreani C, Schved J F
机构信息
Hôpital Privé les Franciscaines, Nîmes, France.
Hôpital Privé les Franciscaines, Nîmes, France.
出版信息
Foot Ankle Surg. 2014 Dec;20(4):285-92. doi: 10.1016/j.fas.2014.08.004. Epub 2014 Aug 19.
BACKGROUND
Ankle arthropathy is very frequent in haemophilic patients. Prostheses are valuable alternatives to arthrodesis in non-haemophilic patients. We report the experience of a single centre in France on the use of prostheses in haemophilic patients.
METHODS
Retrospective study of 21 patients with haemarthropathy who underwent ankle arthroplasty (32 ankles), with additional surgery, if needed, from July 2002 to September 2009 (mean follow-up 4.4±1.7 years). The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale was used to evaluate pain, function, ankle mobility and alignment.
RESULTS
The overall AOFAS score improved from 40.2±19.4 (pre-surgery) to 85.3±11.4 (post-surgery). The function score increased from 23.6±7.7 to 35.9±6.7 and dorsiflexion from 0.3°±5.0° to 10.3°±4.4°. Two patients underwent further ankle arthrodesis. On X-ray, both tibial and talar components were stable and correctly placed in all ankles. Alignment was good.
CONCLUSION
Ankle arthroplasty is a promising alternative to arthrodesis in haemophilic patients.
背景
踝关节病在血友病患者中非常常见。对于非血友病患者，假体是关节融合术的重要替代方案。我们报告了法国一家单一中心在血友病患者中使用假体的经验。
方法
对2002年7月至2009年9月期间接受踝关节置换术（32例踝关节）的21例血友病性关节病患者进行回顾性研究，必要时进行额外手术（平均随访4.4±1.7年）。采用美国矫形足踝协会（AOFAS）踝-后足评分量表评估疼痛、功能、踝关节活动度和对线情况。
结果
AOFAS总分从术前的40.2±19.4提高到术后的85.3±11.4。功能评分从23.6±7.7提高到35.9±6.7，背屈角度从0.3°±5.0°提高到10.3°±4.4°。2例患者接受了进一步的踝关节融合术。X线检查显示，所有踝关节的胫骨和距骨假体均稳定且位置正确。对线良好。
结论
对于血友病患者，踝关节置换术是一种有前景的关节融合术替代方案。
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