Major arthrodeses in patients with neuropathic arthropathy

Sticha, Russell S.; Frascone, Stephen T.; Wertheimer, Stuart J.

doi:10.1016/s1067-2516(96)80130-x

Cited by 23 publications

(4 citation statements)

References 11 publications

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“…Surgical correction of deformities has been used with variable results in chronic CN. Techniques such as arthrodesis [82,116], exostectomies [117], reconstruction [118,119,120] and Achilles tendon lengthening [121] have been carried out. In one of the largest series, 221 cases of CN were reported, whereby surgical arthrodesis was indicated in two-thirds of the hind foot in CN patients, whereas only one-third of the mid-tarsal joint CN required surgery [123].…”

Section: Managementmentioning

confidence: 99%

Charcot neuroarthropathy in diabetes mellitus

et al. 2002

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Charcot neuroarthropathy has been recognised for over 130 years and yet it remains a major cause of morbidity for patients with diabetes mellitus and a continuing challenge for physicians. It is rare but it seems to be increasing in prevalence and this provides hope that with larger studies it will soon be possible to clarify the natural history and optimal treatment regimens. The underlying cause is thought to be trauma in a neuropathic foot that leads to a complex series of pathological processes culminating in bone and joint destruction and subsequent deformity. The acute reaction is often misdiagnosed and many patients present late with established deformity. Even when the diagnosis is considered at an early stage there are no definitive criteria or tests to confirm charcot neuroarthropathy and a high index of suspicion is necessary in any diabetic patient with a swollen warm foot in the presence of somatic or autonomic neuropathy. Treatment has traditionally involved the use of various methods to avoid weight bearing but recent work has begun to suggest that bisphosphonates might be able to arrest the acute process. In the long term, treatment involves a multidisciplinary approach aimed at providing appropriate footwear to reduce plantar pressures and avoid foot ulceration; in some circumstances this involves surgical correction of deformities before adequate footwear can be supplied. Further studies of the emerging treatments for Charcot neuroarthropathy are needed to provide long-term outcome data on morbidity and deformity.

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Section: Managementmentioning

confidence: 99%

Charcot neuroarthropathy in diabetes mellitus

et al. 2002

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“…Arthrodesis is the most common procedure found among studies for Charcot reconstruction. It is beneficial to patients with instability, pain or recurrent ulceration that fails conservative management ( 28 – 33 ). In this review, eight out of 16 studies performed tibiotalocalcaneal arthrodesis to reconstruct Charcot neuroarthropathy of the ankle with 346 cases (63%) recorded ( 10 , 11 , 14 , 15 , 19 , 20 , 23 , 24 ).…”

Section: Discussionmentioning

confidence: 99%

Charcot Neuroarthropathy: Current Surgical Management and Update. A Systematic Review

et al. 2022

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BackgroundCharcot neuroarthropathy of the ankle and the hindfoot is a complex clinical entity with a high risk of amputation. Charcot neuroarthropathy limb reconstruction has been proposed as a limb-salvaging procedure. However, there was a lack of information on the various available reconstruction methods, including the outcomes and complications. The present study aimed to evaluate the current literature and update on the trends regarding the surgical management of Charcot neuroarthropathy of the ankle and the hindfoot.MethodsAll data published from January 2010 to January 2020 that investigated the methods of fixation and their respective outcomes for the surgical reconstruction in Charcot neuroarthropathy were analyzed. The union rate, amputation rates, and complications associated with these techniques were taken for statistical analysis.ResultsA total of 16 studies fit the inclusion criteria of this study, with four Level-III studies and 12 Level-IV studies were included. Ten studies utilized internal fixation only; five used a combination of internal fixation and circular external fixator, whereby there are three comparative studies between internal and external fixations, and two studies applied combined technique of internal and external fixations (hybrid fixation). One study describes the usage of circular external fixation only.ConclusionsThe use of retrograde intramedullary nail as a treatment of choice in the reconstruction of Charcot neuroarthropathy ankle is recommended before an ulcer occurrence. Hydroxyapatite (HA)- coated screws are recommended for the locking mechanism to prevent migration in Charcot neuroarthropathy due to poor bony quality. Hybrid fixation is recommended for reconstruction in a condition of ulceration and more complex deformity as it provides a higher rate of limb salvage with less soft tissue irritation.

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“…In 1993, Papa et al 4 described the use of external fixation in four of 29 patients with neuropathic arthropathy. Case reports by Sticha et al 5 and Prokuski and Saltzman 6 followed, both describing good results. In 2002, Cooper 7 reported his personal experience of his first 100 cases using the Ilizarov technique for Charcot correction.…”

Section: Recent Literaturementioning

confidence: 97%

The role of circular fixation in the treatment of Charcot foot

Wukich

Lowery

2010

Current Orthopaedic Practice

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Charcot neuroarthropathy of the foot and ankle is a challenging clinical dilemma. No clear consensus exists regarding the timing of surgical intervention or the method of treatment. Over the last decade, circular ring fixation has gained favor in the treatment of the Charcot foot. Review of the literature reveals that most series report favorable results and low amputation rates. This is based largely on retrospective case series and not prospective randomized control trials. Circular fixators also have inherent complications such as pin breakage and infection. The use of circular ring fixation, however, is a useful method in the surgical management of selected patients with Charcot neuroarthropathy.

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Major arthrodeses in patients with neuropathic arthropathy

Cited by 23 publications

References 11 publications

Charcot neuroarthropathy in diabetes mellitus

Charcot neuroarthropathy in diabetes mellitus

Charcot Neuroarthropathy: Current Surgical Management and Update. A Systematic Review

The role of circular fixation in the treatment of Charcot foot

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