Long-term Follow-up of Tibiocalcaneal Arthrodesis in Diabetic Patients with Early Chronic Charcot Osteoarthropathy

Prevalence of Peripheral Arterial Disease in Patients With Diabetic Charcot Neuroarthropathy

“…The reported rates of PAD in patients with CN have ranged from 4.4% to 35.4% (21)(22)(23)(24). Most of these studies did not specifically evaluate the prevalence of PAD but, rather, reported on a series of patients with CN (21)(22)(23). The precise definition of PAD was not well defined in these studies.…”

“…The precise definition of PAD was not well defined in these studies. Caravaggi et al (21) reported a rate of 4.4% and only included patients with critical limb ischemia using a threshold of transcutaneous oxygen pressure of 30 mm Hg. Another center published a case report and a series of 10 patients with critical limb ischemia and CN (25,26).…”

Conservative and surgical treatment of the chronic Charcot foot and ankle

“…These can be single or staged procedures, based on the presence of infection and may require osteotomy with autografting. If there is a suspicion of infection, staged procedures may be required than a single stage surgery (61–63). Therefore, the type of the surgical approach depends on many factors, including the severity and location of deformity, stability, and presence or absence of infection.…”

“…Intramedullary nails can be used successfully for internal fixation of chronic CN treatment. In the series by Caravaggi et al, tibiocalcaneal intramedullary devices offer an alternative for Brodsky type 2 (involves the subtalar and/or the Chopart joints) and type 3 (involves the ankle joint) deformities (61). Most fusion techniques usually require a brace or cast with or without partial weightbearing for 3 months, which is mostly followed by prolonged or permanent protective bracing (58, 59, 62).…”

“…There are some case series involving arthrodesis for limb salvage that have resulted in relatively successful results. The study by Caravaggi et al included 45 diabetic patients who underwent unilateral ankle arthrodesis for CN before the development of ulceration and bone infection, and after a 5-year follow-up, 39 patients (86.67%) returned to independent ambulation wearing (61). …”