title: Comparison of total ankle replacement and ankle arthrodesis in patients with haemophilia using gait analysis: two case reports.
abstract: BACKGROUND
  Severe hemophilia is an inherited, lifelong bleeding disorder characterized by spontaneous bleeding, which results in painful joint deformities. Currently two surgical treatments are available to treat haemophilia-related ankle joint destruction: ankle arthrodesis and total ankle replacement. The aim of the present study was to compare these two surgical procedures in haemophiliac subjects.
  
  
  METHODS
  Kinematic and dynamic parameters were quantified using a three-dimensional gait-analysis system in two similar clinical cases. In Caucasian case 1, ankle arthrodesis was chosen because of a kinematic ankle flexion defect and lack of dynamic power regeneration. The defect in energy absorption was compensated for by the contralateral side. Total ankle replacement in Caucasian case 2 allowed sparing the ipsilateral knee (maximum 0.27 preoperatively vs. 0.71 W/kg postoperatively) and hip joints powers (maximum 0.43 preoperatively vs. 1.25 W/kg postoperatively) because of the small ankle dorsiflexion motion.
  
  
  CONCLUSIONS
  Total ankle replacement is recommended for haemophiliac patients who present with a preserved ankle range of motion.
authors.affiliation: CHU Nantes, Pôle de MPR, Hôpital Saint Jacques, 85 rue Saint Jacques, 44093, Nantes Cedex 01, France. marc.dauty@chu-nantes.fr.
authors.forename: Marc
authors.initials: M
authors.lastname: Dauty
authors.affiliation: CHU Nantes, Pôle de MPR, Hôpital Saint Jacques, 85 rue Saint Jacques, 44093, Nantes Cedex 01, France. raphael.gross@chu-nantes.fr.
authors.forename: Raphael
authors.initials: R
authors.lastname: Gross
authors.affiliation: CHU Nantes, Pôle de MPR, Hôpital Saint Jacques, 85 rue Saint Jacques, 44093, Nantes Cedex 01, France. fabien.leboeuf@chu-nantes.fr.
authors.forename: Fabien
authors.initials: F
authors.lastname: Leboeuf
authors.affiliation: CHU Nantes, Centre Régional de Traitement de l'Hémophilie, Hôtel Dieu, 44035, Nantes Cedex 03, France. marc.trossaert@chu-nantes.fr.
authors.forename: Marc
authors.initials: M
authors.lastname: Trossaert
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000503:physiopathology / Q000601:surgery*; D001174:Arthrodesis / Q000379:methods*; D058737:Arthroplasty, Replacement, Ankle / Q000379:methods*; D001696:Biomechanical Phenomena; D005684:Gait; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D007592:Joint Diseases / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D016059:Range of Motion, Articular; D016896:Treatment Outcome