Physiotherapy after Total Ankle Replacement in a patient with haemophilia – a case study

Abstract

Introduction

Haemophilia manifests itself with spontaneous and posttraumatic bleeds, most often to joints, muscles, viscera and Central Nervous System (CNS), causing degenerative changes. Advanced arthropathy of the ankle joint occurs even in young adults with haemophilia. The aim of this study was to present the physiotherapy process and its effect after Total Ankle Replacement (TAR) of the ankle joint in a patient with haemophilia.

Material and methods

A 42-year-old patient with moderate haemophilia B after total ankle replacement of the ankle joint attended physiotherapy in a day-care ward setting. The AOFAS Scale (American Orthopaedic Foot and Ankle Society ankle-hindfoot scale) has been used to assess the effectiveness of the treatment, VAS scale (Visual Analog Scale) to assess level of pain, TUG test (Timed Up and Go) to assess dynamic and static balance, the range of motion in the ankle joint was measured using goniometer and the muscle strength was assessed with using Lovett scale.

Conclusions

Function of the ankle joint significantly improved, the level of pain decreased and time needed to complete the TUG test shortened. The range of motion as well as strength of the muscles acting on the ankle joint improved slightly.