Dataset Information

Long-term follow-up of conservative treatment of Charcot feet.

ABSTRACT:

Background

Charcot arthropathy (CN) can ultimately lead to limb loss despite appropriate treatment. Initial conservative treatment is the accepted treatment in case of a plantigrade foot. The aim of this retrospective study was to investigate the mid- to long-term clinical course of CN initially being treated conservatively, and to identify risk factors for reactivation and contralateral development of CN as well as common complications in CN.

Methods

A total of 184 Charcot feet in 159 patients (median age 60.0 (interquartile range (IQR) 15.5) years, 49 (30.1%) women) were retrospectively analyzed by patient chart review. Rates of limb salvage, reactivation, contralateral development and common complications were recorded. Statistical analysis was performed to identify possible risk factors for limb loss, CN reactivation, contralateral CN development, and ulcer development.

Results

Major amputation-free survival could be achieved in 92.9% feet after a median follow-up of 5.2 (IQR 4.25, range 2.2-11.25) years. CN recurrence occurred in 13.6%. 32.1% had bilateral CN involvement. Ulcers were present in 72.3%. 88.1% patients were ambulating in orthopaedic footwear without any further aids. Presence of Diabetes mellitus was associated with reactivation of CN, major amputation and ulcer recurrence. Smoking was associated with ulcer development and necessity of amputations.

Conclusions

With consistent conservative treatment of CN with orthopaedic footwear or orthoses, limb preservation can be achieved in 92.9% after a median follow-up of 5.2 years. Patients with diabetic CN are at an increased risk of developing complications and CN reactivation. To prevent ulcers and amputations, every effort should be made to make patients stop smoking.

Level of evidence

III, long-term retrospective cohort study.

SUBMITTER: Gratwohl V

PROVIDER: S-EPMC9474498 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Publications

Long-term follow-up of conservative treatment of Charcot feet.

Gratwohl Viviane V Jentzsch Thorsten T Schöni Madlaina M Kaiser Dominik D Berli Martin C MC Böni Thomas T Waibel Felix W A FWA

Archives of orthopaedic and trauma surgery 20210407 10

<h4>Background</h4>Charcot arthropathy (CN) can ultimately lead to limb loss despite appropriate treatment. Initial conservative treatment is the accepted treatment in case of a plantigrade foot. The aim of this retrospective study was to investigate the mid- to long-term clinical course of CN initially being treated conservatively, and to identify risk factors for reactivation and contralateral development of CN as well as common complications in CN.<h4>Methods</h4>A total of 184 Charcot feet i ...[more]

PMID: 33829302

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Dataset Information

Long-term follow-up of conservative treatment of Charcot feet.

Background

Methods

Results

Conclusions

Level of evidence

Publications

Long-term follow-up of conservative treatment of Charcot feet.

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