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Improvement in Quality of Life Following Operative Correction of Midtarsal Charcot Foot Deformity.
Foot Ankle Int. 2018 07; 39(7):808-811.FA

Abstract

BACKGROUND

Patients with Charcot foot arthropathy report a poor quality of life following the development of deformity. Their quality of life is often not improved with "successful" historic accommodative treatment. There is increased current interest in operative correction of the acquired deformity with the stated goals of achieving both the traditional goals of resolution of infection and limb salvage as well as the desire to improve quality of life. The Short Musculoskeletal Functional Assessment (SMFA) outcomes instrument appears to be a valid tool for evaluating this complex patient population.

METHODS

Twenty-five consecutive patients undergoing operative reconstruction for nonplantigrade midtarsal Charcot foot arthropathy completed the SMFA patient-reported outcomes instrument prior to surgery, with 24 completing it at 1 year following the surgery. One patient died during the year following surgery from unrelated causes.

RESULTS

There was an 11.5-point (95% confidence interval [CI]: -19.7 to -3.2) decrease in the standardized functional index (P = .01). Similarly, there was a 12.4-point (95% CI: -22.5 to -2.3) decrease in the standardized bother index (P = .02). The standardized daily activity index demonstrated a 19.6-point decrease (95% CI: -30.5 to -8.6, P = .002), and there was a 14.7-point (95% CI: -24.1 to -5.3) decrease in the standardized emotion index (P = .004). There was no meaningful change in the standardized arm/hand index (P = .81).

CONCLUSION

The results of this investigation demonstrate that successful operative reconstruction of midtarsal Charcot foot arthropathy improved quality of life. This supports the modern paradigm shift from immobilization during the active phase of the disease process followed by simple accommodation of the acquired deformity to the modern interest in operative correction to allow the use of commercially available therapeutic footwear.

LEVEL OF EVIDENCE

Level IV, case series.

Authors+Show Affiliations

1 Department of Orthopaedic Surgery & Rehabilitation, Loyola University Health System, Maywood, IL, USA.2 Loyola University Medical School, Maywood, IL, USA.1 Department of Orthopaedic Surgery & Rehabilitation, Loyola University Health System, Maywood, IL, USA.1 Department of Orthopaedic Surgery & Rehabilitation, Loyola University Health System, Maywood, IL, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29609479

Citation

Kroin, Ellen, et al. "Improvement in Quality of Life Following Operative Correction of Midtarsal Charcot Foot Deformity." Foot & Ankle International, vol. 39, no. 7, 2018, pp. 808-811.
Kroin E, Chaharbakhshi EO, Schiff A, et al. Improvement in Quality of Life Following Operative Correction of Midtarsal Charcot Foot Deformity. Foot Ankle Int. 2018;39(7):808-811.
Kroin, E., Chaharbakhshi, E. O., Schiff, A., & Pinzur, M. S. (2018). Improvement in Quality of Life Following Operative Correction of Midtarsal Charcot Foot Deformity. Foot & Ankle International, 39(7), 808-811. https://doi.org/10.1177/1071100718762138
Kroin E, et al. Improvement in Quality of Life Following Operative Correction of Midtarsal Charcot Foot Deformity. Foot Ankle Int. 2018;39(7):808-811. PubMed PMID: 29609479.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improvement in Quality of Life Following Operative Correction of Midtarsal Charcot Foot Deformity. AU - Kroin,Ellen, AU - Chaharbakhshi,Edwin O, AU - Schiff,Adam, AU - Pinzur,Michael S, Y1 - 2018/04/02/ PY - 2018/4/4/pubmed PY - 2019/4/13/medline PY - 2018/4/4/entrez KW - Charcot foot KW - deformity KW - diabetic foot SP - 808 EP - 811 JF - Foot & ankle international JO - Foot Ankle Int VL - 39 IS - 7 N2 - BACKGROUND: Patients with Charcot foot arthropathy report a poor quality of life following the development of deformity. Their quality of life is often not improved with "successful" historic accommodative treatment. There is increased current interest in operative correction of the acquired deformity with the stated goals of achieving both the traditional goals of resolution of infection and limb salvage as well as the desire to improve quality of life. The Short Musculoskeletal Functional Assessment (SMFA) outcomes instrument appears to be a valid tool for evaluating this complex patient population. METHODS: Twenty-five consecutive patients undergoing operative reconstruction for nonplantigrade midtarsal Charcot foot arthropathy completed the SMFA patient-reported outcomes instrument prior to surgery, with 24 completing it at 1 year following the surgery. One patient died during the year following surgery from unrelated causes. RESULTS: There was an 11.5-point (95% confidence interval [CI]: -19.7 to -3.2) decrease in the standardized functional index (P = .01). Similarly, there was a 12.4-point (95% CI: -22.5 to -2.3) decrease in the standardized bother index (P = .02). The standardized daily activity index demonstrated a 19.6-point decrease (95% CI: -30.5 to -8.6, P = .002), and there was a 14.7-point (95% CI: -24.1 to -5.3) decrease in the standardized emotion index (P = .004). There was no meaningful change in the standardized arm/hand index (P = .81). CONCLUSION: The results of this investigation demonstrate that successful operative reconstruction of midtarsal Charcot foot arthropathy improved quality of life. This supports the modern paradigm shift from immobilization during the active phase of the disease process followed by simple accommodation of the acquired deformity to the modern interest in operative correction to allow the use of commercially available therapeutic footwear. LEVEL OF EVIDENCE: Level IV, case series. SN - 1944-7876 UR - https://www.unboundmedicine.com/medline/citation/29609479/Improvement_in_Quality_of_Life_Following_Operative_Correction_of_Midtarsal_Charcot_Foot_Deformity_ L2 - https://journals.sagepub.com/doi/10.1177/1071100718762138?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -