Year: 2025
Type: article
Study design: Observational Study
Abstract: Background In Charcot neuro-osteoarthropathy (CNO), deformity-induced ulcers significantly increase the risk of amputation. Reconstructive foot surgery (RFS) is essential to prevent this, but peripheral artery disease (PAD) and diabetes increase complication risks. Methods All patients from a single center treated with RFS for midfoot CNO between 2019 and 2023 were included. Treatment followed a multidisciplinary protocol aimed at optimizing 4 factors: hyperglycemia, infection, pressure, and arterial blood flow. Results Seventeen patients were included (mean follow-up 20 months). Sixteen patients (94%) achieved an ulcer-free, plantigrade foot. No amputations were performed. Fifteen patients (88%) were diabetic, 67% of whom had elevated HbA 1c levels, and 80% of these normalized after treatment. Four patients had PAD (24%), of whom 2 required revascularization. Deep infections occurred in 4 (24%) cases, and 6 (35%) required additional surgery. Conclusions Ulcer-free and good functional outcomes can be achieved, and amputation prevented, in patients with midfoot CNO provided they are treated by a multidisciplinary team. Level of Evidence: Level IV, case series
Source: Foot & Ankle Specialist
Institution: Alrijne Ziekenhuis
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4409830642