Total Ankle Replacement in Hemophilia.

The objective of this paper is to carry out a review of the literature on the contemporary situation of total ankle replacement (TAR) in people with hemophilia (PWH). A search was performed in PubMed on December 29, 2024, utilizing the keywords "hemophilia" and "total ankle replacement." To date solely 8 papers (136 TARs) in 103 PWH have been reported. All published series showed improvement in preoperative pain and function. However, the complication rate was 8.8% (intra-operative fractures of the medial malleolus, delayed wound healings, hematomas). Additional surgery is required in 5.1% of the TARs implanted (ankle arthrolysis due to painful arthrofibrosis, major surgeries, revision surgeries). The estimated 10-year survival free of any TAR removal or ankle fusion (AF) is 92.2%. Regarding the controversy AF or TAR in PWH, a recent systematic review and meta-analysis have found similar clinical results and rates of adverse events between TAR and AF in PWH.