ABSTRACT
The standard treatment for end-stage osteoarthritis of the ankle joint in haemophilic patients has been fusion of the ankle joint. Total ankle replacement is still controversial as a treatment option. The objective of this prospective study was to evaluate the mid-term outcome in patients treated with total ankle replacement using an unconstrained three-component ankle implant. Ten haemophilic ankles in eight patients (mean age: 43.2 years, range 26.7-57.5) treated with total ankle replacement were followed up for a minimum of 2.7 years (mean: 5.6, range 2.7-7.6). The outcome was measured with clinical and radiological evaluations. There were no intra- or peri-operative complications. The AOFAS-hindfoot-score increased from 38 (range 8-57) preoperatively to 81 (range 69-95) postoperatively. All patients were satisfied with the results. Four patients became pain free; in the whole patient cohort pain level decreased from 7.1 (range 4-9) preoperatively to 0.8 (range 0-3) postoperatively. All categories of SF-36 score showed significant improvements in quality of life. In one patient, open ankle arthrolysis was performed because of painful arthrofibrosis. For patients with haemophilic osteoarthritis of the ankle joint, total ankle replacement is a valuable alternative treatment to ankle fusion.
Subject(s)
Ankle Joint/surgery , Arthroplasty, Replacement , Hemarthrosis/surgery , Hemophilia A/complications , Joint Prosthesis , Adult , Ankle Joint/diagnostic imaging , Arthroplasty, Replacement/methods , Factor VIII/therapeutic use , Female , Hemarthrosis/drug therapy , Hemophilia A/drug therapy , Humans , Male , Middle Aged , Patient Satisfaction , Prospective Studies , Radiography , Recombinant Proteins/therapeutic useABSTRACT
Trauma is the leading cause of death in the United States for persons less than 40 years of age. It is the fourth leading cause of death in persons of all ages. Over 60 million injuries occur annually, therefore multiply injured patients represent a large portion of hospital admissions (Cordona, Hurd, Mason, et al., 1994; Geerts, Code, Jay, et al., 1994) Due to the complexity of patient care, and the potential for complications, nurses caring for these patients must be knowledgeable of their role in the patient's management and recovery. The following case scenario represents a typical multiply-injured patient and discusses common potential complications and how the nurse can intervene to prevent these complications from occurring.
