The Journal of Bone and Joint Surgery, Vol 73, Issue 7 1008-1015, Copyright © 1991 by Journal of Bone and Joint Surgery, Inc
Arthropathy of the ankle in hemophilia
JG Gamble, J Bellah, LA Rinsky and B Glader
Division of Orthopaedic Surgery, Children's Hospital, Stanford, Palo Alto, California 94304.
Seventy-five patients who had hemophilia were followed clinically and
roentgenographically to assess the prevalence of hemarthrosis and the
prevalence and severity of arthropathy of the ankle. The mean age of the
patients at the time of follow-up was twenty-two years and seven months.
The patients were divided into four age-groups: less than ten years (eleven
patients), ten to nineteen years (twenty-one patients), twenty to thirty
years (twenty-four patients), and more than thirty years (nineteen
patients). Intra-articular bleeding occurred more frequently in the joints
of the lower extremities than in the joints of the upper extremities.
During the second decade of life, hemarthroses occurred more often in the
ankle than in the knee. A history of recurrent bleeding into the ankle
joint, chronic synovitis, and overgrowth of the medial portion of the
distal tibial epiphysis was associated with an early onset of arthropathy.
In older patients, compression arthrodesis of the ankle joint was helpful
in eliminating pain, recurrent bleeding, and equinus deformity.
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