A comparison of arthrodesis and arthroplasty for hemophilic arthropathy of the ankle: a systematic review

Abstract

Objective: To conduct a systematic review of the literature on surgical treatment for end-stage hemophilic arthropathy of the ankle joint, describing the results for arthroplasty and arthrodesis. Methods: We conducted a systematic literature review according to Cochrane (Cochrane Handbook for Systematic Reviews of Interventions version 6.1, 2020) and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations. The primary outcome was clinical improvement in pain and function of the affected limb. Secondary outcomes included adverse effects and complications from the surgical procedures. Results: After reviewing 514 studies, 10 were included for data extraction and qualitative analysis (180 patients: 100 arthroplasties and 117 arthrodeses). Conclusions: Both methods showed low overall complication rates and effectively reduced pain and improved function, allowing a return to work, activities of daily living and, in some cases, sports. One procedure was not clearly better than the other: the choice must be based on the patient’s characteristics and clinical judgment. Level of Evidence III; Therapeutic Studies; Systematic Review of Level III Studies.