Long-Term Outcomes of a Novel Surgical Approach for Early Charcot Neuroarthropathy
Abstract
Background: Charcot neuroarthropathy (CN) of the foot is a progressive condition associated with significant deformity and recurrent ulceration. Despite advancements in imaging and classification, management remains challenging. Traditional nonsurgical treatments have shown limited success in preventing disease progression, while surgical interventions often involve prolonged nonweight-bearing periods and high complication rates.
Methods: This study presents an 8-year follow-up of 15 patients (Evidence Level IV) undergoing a novel early surgical intervention for Stage 0-1 CN with preoperative plantigrade alignment. The procedure involved fluoroscopically guided filling of subchondral defects using a flowable calcium phosphate compound and realignment with dynamic circular external fixation in 14 of 15 subjects. Assisted weight-bearing began 3-5 days postoperatively, with fixation removed after 6-8 weeks. Radiographic parameters (Meary's angle, calcaneal inclination angle, talar declination angle, and cuboid height) were assessed preoperatively and at final follow-up.
Results: Thirteen of 15 subjects survived the 8 years. No surgical complications, ipsilateral CN, or midfoot ulcerations occurred. Radiographic alignment remained stable over 8 years (p < 0.01 for all parameters).
Conclusion: Early surgical intervention with subchondral defect filling and external fixation appears to stabilize osseous architecture, prevent midfoot collapse, and expedite recovery in CN. Larger…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 15 participants or records.
Read the paper
Related studies
- Irisin Enhances Osteoblast DifferentiationIn Vitro
- Glucocorticoids suppress Wnt16 expression in osteoblasts in vitro and in vivo
- Interaction between Schwann Cells and Osteoblasts In Vitro
- Administration of cinnamaldehyde promotes osteogenesis in ovariectomized rats and differentiation of osteoblast in vitro
- The Effect of the Major Components of Fructus Cnidii on Osteoblasts In Vitro
- Estrogen depletion alters osteogenic differentiation and matrix production by osteoblasts in vitro
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.