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.