Charcot Neuroarthropathy of the Foot and Ankle

Abstract

➤ Charcot neuroarthropathy (CN) is a systemic disease that generates pathological changes in the musculoskeletal system, causing fractures, dislocations, and deformities involving the foot and ankle.➤ A common underlying cause of CN is diabetes mellitus; a substantial risk of ulceration and deep infection contributes to a 15% rate of major amputation (i.e., at the level of the ankle or higher).➤ The goal of both nonsurgical and surgical treatment of CN is to obtain a stable, plantigrade foot free from ulcerations; an equally important goal is to manage the patient’s diabetes and obesity.➤ The primary indications for surgery are recurrent ulceration, substantial deformity, deep infection, and pain; common complications include nonunion, wound breakdown, and infection.➤ The principles of thorough joint preparation, deformity correction, and minimizing soft-tissue trauma are essential when arthrodesis is performed for CN, which requires more robust (internal and/or external) fixation and prolonged off-loading.

Charcot neuroarthropathy of the knee due to idiopathic sensory peripheral neuropathy

“…Historically, the 2 dominant pathophysiological causes of Charcot neuroarthropathy included the neurotraumatic (abnormal sensory innervation, repeated microtrauma, and unregulated inflammatory cascade) and neurovascular theories (hypervascular region in subchondral bone, vascular shunting, and subsequent osteopenia) [1,3]. Peripheral neuropathy caused by diabetes mellitus is the main cause of Charcot neuroarthropathy of the knee.…”

“…Diabetes is the most common etiology. Charcot neuroarthropathy is considered a major risk factor for below-the-knee amputation among the diabetics [1], while upper extremity can also be affected as a result of syringomyelia [5]. The diagnosis of Charcot neuroarthropathy is based primarily on thorough history and physical examination, including features, such as loss of protective sensation, presence of ulceration, and warm, swollen, erythematous foot and/or ankle.…”

“…Charcot neuroarthropathy is a systemic disease that generates pathological changes in the musculoskeletal system, causing instability, dislocations, and deformities [1], first named by Jean Martin Charcot (1829-1893) in 1868 [2]. Diabetes mellitus and neurosyphilis are the most common causes of Charcot neuroarthropathy these days, mostly affecting the foot and ankle [3].…”

Syphilis with Charcot arthropathy: A case report

“…The Charcot arthropathy was first described in a patient with tertiary syphilis by Doctor Charcot in 1868 (Dodd & Daniels, ). It is usually secondary to primary neurologic disease like diabetic neuropathy, syringomyelia, myelomeningocele, and syphilitic tabes dorsalis.…”

“…The Charcot arthropathy was first described in a patient with tertiary syphilis by Doctor Charcot in 1868 (Dodd & Daniels, 2018). It is…”