Patients who underwent ankle arthrodesis in the coalescence or remodeling stages of Charcot osteoarthropathy before the onset of joint instability, severe deformity and ulcer formation had satisfactory outcomes, according to study published in the Journal of Foot and Ankle Surgery.
Researchers enrolled 45 patients with diabetes who had Charcot neuroarthropathic ankle and hind foot deformity before the development of ulceration and bone infection. Patients underwent tibiocalcaneal arthrodesis if the degree of ankle and hindfoot instability and deformity was advanced enough that ongoing bracing was difficult and associated with cutaneous compromise.
In the study, 39 (86.67%) patients returned to independent ambulation wearing custom-made shoes with molded insoles after a mean follow-up of 5 years. Two (4.44%) patients required pneumatic casts for ambulation and 4.44% of the patients underwent transtibial amputation shortly after the ankle arthrodesis because of postoperative infection. Additionally, 4.44% of the patients were lost to follow-up
Researchers found no patients had recurring ulcers during the follow-up period.
“Ongoing clinical research is necessary to formulate a better understanding of the optimal method of treatment for Charcot osteoarthropathy of the hindfoot and ankle,” the researchers stated.
For more information:
Caravaggi CMF. J Foot Ankle Surg. 2012;51:408-411.
Disclosure: The researchers report no relevant financial disclosures.