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Treatment of Hemophilic Ankle Arthropathy with One-Step Arthroscopic Bone Marrow–Derived Cells Transplantation

OBJECTIVE: Ankle arthropathy is a frequent and invalidating manifestation of hemophilia. Arthrodesis is the gold standard surgical procedure in end-stage disease, with many drawbacks in young patients. Recent literature has shown increase interest in regenerative procedures in hemophilic arthropathy...

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Autores principales: Buda, Roberto, Cavallo, Marco, Castagnini, Francesco, Cenacchi, Annarita, Natali, Simone, Vannini, Francesca, Giannini, Sandro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4481389/
https://www.ncbi.nlm.nih.gov/pubmed/26175860
http://dx.doi.org/10.1177/1947603515574286
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author Buda, Roberto
Cavallo, Marco
Castagnini, Francesco
Cenacchi, Annarita
Natali, Simone
Vannini, Francesca
Giannini, Sandro
author_facet Buda, Roberto
Cavallo, Marco
Castagnini, Francesco
Cenacchi, Annarita
Natali, Simone
Vannini, Francesca
Giannini, Sandro
author_sort Buda, Roberto
collection PubMed
description OBJECTIVE: Ankle arthropathy is a frequent and invalidating manifestation of hemophilia. Arthrodesis is the gold standard surgical procedure in end-stage disease, with many drawbacks in young patients. Recent literature has shown increase interest in regenerative procedures in hemophilic arthropathy, which may be desirable to delay or even avoid arthrodesis. The aim of this article is to present five cases of osteochondral lesions in ankle hemophilic arthropathy treated with a regenerative procedure: bone marrow–derived cells transplantation (BMDCT). DESIGN: We report five hemophilic patients (four cases with hemophilia type A; one case with hemophilia type B) who have undergone BMDCT treatment, synovectomy, and arthroscopic debridement, with the use of autologous platelet-rich fibrin, to treat osteochondral lesions in hemophilic ankle arthropathy. The patients, included within this retrospective study, were clinically and radiologically evaluated with serial follow-ups, using the American Orthopaedic Foot and Ankle Society (AOFAS) scores, radiographs, and magnetic resonance imaging (MRI). RESULTS: The mean preoperative AOFAS score was 35. After a mean follow-up of 2 years, the mean postoperative AOFAS score was 81, which included three patients returning back to sporting activities. The MRI Mocart score demonstrated signs of regeneration of chondral and bony tissue. No progression of joint degeneration was shown radiographically. CONCLUSION: BMDCT is a promising regenerative treatment for osteochondral lesions in mild ankle hemophilic arthropathy, which may be useful to delay or even avoid ankle arthrodesis. Nevertheless, longer follow-ups and a larger case series are required.
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spelling pubmed-44813892016-07-01 Treatment of Hemophilic Ankle Arthropathy with One-Step Arthroscopic Bone Marrow–Derived Cells Transplantation Buda, Roberto Cavallo, Marco Castagnini, Francesco Cenacchi, Annarita Natali, Simone Vannini, Francesca Giannini, Sandro Cartilage Article OBJECTIVE: Ankle arthropathy is a frequent and invalidating manifestation of hemophilia. Arthrodesis is the gold standard surgical procedure in end-stage disease, with many drawbacks in young patients. Recent literature has shown increase interest in regenerative procedures in hemophilic arthropathy, which may be desirable to delay or even avoid arthrodesis. The aim of this article is to present five cases of osteochondral lesions in ankle hemophilic arthropathy treated with a regenerative procedure: bone marrow–derived cells transplantation (BMDCT). DESIGN: We report five hemophilic patients (four cases with hemophilia type A; one case with hemophilia type B) who have undergone BMDCT treatment, synovectomy, and arthroscopic debridement, with the use of autologous platelet-rich fibrin, to treat osteochondral lesions in hemophilic ankle arthropathy. The patients, included within this retrospective study, were clinically and radiologically evaluated with serial follow-ups, using the American Orthopaedic Foot and Ankle Society (AOFAS) scores, radiographs, and magnetic resonance imaging (MRI). RESULTS: The mean preoperative AOFAS score was 35. After a mean follow-up of 2 years, the mean postoperative AOFAS score was 81, which included three patients returning back to sporting activities. The MRI Mocart score demonstrated signs of regeneration of chondral and bony tissue. No progression of joint degeneration was shown radiographically. CONCLUSION: BMDCT is a promising regenerative treatment for osteochondral lesions in mild ankle hemophilic arthropathy, which may be useful to delay or even avoid ankle arthrodesis. Nevertheless, longer follow-ups and a larger case series are required. SAGE Publications 2015-07 /pmc/articles/PMC4481389/ /pubmed/26175860 http://dx.doi.org/10.1177/1947603515574286 Text en © The Author(s) 2015
spellingShingle Article
Buda, Roberto
Cavallo, Marco
Castagnini, Francesco
Cenacchi, Annarita
Natali, Simone
Vannini, Francesca
Giannini, Sandro
Treatment of Hemophilic Ankle Arthropathy with One-Step Arthroscopic Bone Marrow–Derived Cells Transplantation
title Treatment of Hemophilic Ankle Arthropathy with One-Step Arthroscopic Bone Marrow–Derived Cells Transplantation
title_full Treatment of Hemophilic Ankle Arthropathy with One-Step Arthroscopic Bone Marrow–Derived Cells Transplantation
title_fullStr Treatment of Hemophilic Ankle Arthropathy with One-Step Arthroscopic Bone Marrow–Derived Cells Transplantation
title_full_unstemmed Treatment of Hemophilic Ankle Arthropathy with One-Step Arthroscopic Bone Marrow–Derived Cells Transplantation
title_short Treatment of Hemophilic Ankle Arthropathy with One-Step Arthroscopic Bone Marrow–Derived Cells Transplantation
title_sort treatment of hemophilic ankle arthropathy with one-step arthroscopic bone marrow–derived cells transplantation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4481389/
https://www.ncbi.nlm.nih.gov/pubmed/26175860
http://dx.doi.org/10.1177/1947603515574286
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