Charcot neuroarthropathy can cause severe deformity of the midfoot, and intramedullary use of beams and bolts has been utilized as a method of definitive stabilization. This systematic review evaluated the outcomes of intramedullary beaming in patients with Charcot neuroarthropathy and determined the methodological quality of the studies. Four online databases were searched: PubMed, MEDLINE (Clarivate Analytics), CINAHL (Cumulative Index to Nursing and Allied Health) and Web of Science (Clarivate Analytics). To assess the methodological quality of the studies, the Coleman Methodology Score was used. The data was pooled into 2 outcomes groups for comparison: (1) Studies that reported on the outcomes of Charcot specific implants (study group). (2) Studies that reported on the outcomes using non-Charcot specific implants (control group). After screening, 16 studies were included. Compared to our control group, our study group had significantly higher rates of overall hardware complications, hardware migration, surgical site infection, reoperation, and nonunion. The study group had significantly lower rates of limb salvage compared to the control group. Our study and control groups did not differ in the rates of hardware breakage, wound healing complications, or mortality. The limb salvage rate was 92% and 97% of patients were still alive at a mean follow-up of 25 months. The mean Coleman Methodology Score indicated the quality of the studies was poor and consistent with methodologic limitations. The quality of published studies on intramedullary implants for Charcot reconstruction is low. Complications when utilizing intramedullary fixation for Charcot reconstruction are high, whether or not Charcot specific implants are used.
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http://dx.doi.org/10.1053/j.jfas.2022.04.009 | DOI Listing |
Aim: Diabetic Charcot neuro-osteoarthropathy carries a significant worldwide disease burden including diabetic foot infection, ulceration and amputation. The current accepted standard of treatment during the active phase of Charcot neuro-osteoarthropathy is offloading with total contact casting; however, controversy remains regarding weight-bearing status during this period.
Methods: A systematic review was performed following PRISMA guidelines of Pubmed, EMBASE, MEDLINE and the Cochrane central register of controlled trials for clinical studies from inception until June 2024 investigating weight-bearing and non-weight-bearing total contact casting for active Charcot neuro-osteoarthropathy.
Can Prosthet Orthot J
August 2024
Department of Rehabilitation Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
J Foot Ankle Res
December 2024
Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
Introduction: Charcot neuroarthropathy (CN) can result in fractures and dislocations of the foot and ankle in individuals with diabetes and neuropathy, leading to ulceration, amputation and a poor quality of life. Additional episodes of acute CN can lead to extended periods of physical and psychosocial distress. The aim of this scoping review was to identify and synthesise the evidence relating to factors associated with the development of recurrent and contralateral Charcot neuroarthropathy (CN) in individuals with diabetes.
View Article and Find Full Text PDFClin Podiatr Med Surg
January 2025
International Center of Limb Lengthening, Rubin Institute of Advanced Orthopedics, 2401 West Belvedere Avenue, Baltimore, MD 21215, USA; Division Of Podiatric Surgery, Sinai Hospital, Baltimore, MD, USA. Electronic address:
Minimally invasive surgery (MIS) continues to develop as a viable alternative to traditional open surgery for various foot and ankle pathologies. The neuropathic foot is one area where MIS can be very beneficial to surgeons and their patients. Improving wound healing and decreasing the surgical footprint and thus reducing complications associated with soft tissue in this population is advantageous.
View Article and Find Full Text PDFCureus
October 2024
Orthopaedics, Dr. D.Y.Patil Medical College, Hospital and Research Centre, Dr. D.Y.Patil Vidyapeeth (Deemed to be University), Pune, IND.
Charcot neuroarthropathy (CN) is a chronic progressive debilitating disease affecting joints, bone and soft tissue of an insensate limb, usually seen in patients with diabetes. CN of the great toe is rare or it may be associated with CN of other joints. Only a few cases have been reported on the CN of the great toe.
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