title: Osteochondral repair in hemophilic ankle arthropathy: from current options to future perspectives.
abstract: Young hemophilic patients are frequently affected by ankle arthropathy. At the end stage of the disease, the current treatments are arthrodesis and arthroplasty, which have significant drawbacks. Validated procedures capable of slowing down or even arresting the progression towards the end stage are currently lacking. This review aims to discuss the rationale for and feasibility of applying, in mild hemophilic ankle arthropathy, the main techniques currently used to treat osteochondral defects, focusing in particular on ankle distraction, chondrocyte implantation, mesenchymal stem cell transplantation, allograft transplantation and the use of growth factors. To date, ankle distraction is the only procedure that has been successfully used in hemophilic ankle arthropathy. The use of mesenchymal stem cells have recently been evaluated as feasible for osteochondral repair in hemophilic patients. There may be a rationale for the use of growth factors if they are combined with the previous techniques, which could be useful to arrest the progression of the degeneration or delay end-stage procedures.
authors.affiliation: I Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Buda
authors.affiliation: I Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Cavallo
authors.affiliation: I Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Castagnini
authors.affiliation: I Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Ferranti
authors.affiliation: I Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Natali
authors.affiliation: I Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Giannini
keywords: ankle; bone marrow concentrate; cartilage; chondrocyte; hemophilia; regenerative technique