- Case of bilateral hip joint Charcot arthropathy in a paediatric patient. [Case Reports]BMJ Case Rep. 2023 Jan 02; 16(1)BC
- An adolescent girl came with swelling of both thighs with difficulty in walking for a few months. Based on clinical, and radiological evaluation and nerve conduction studies, she was diagnosed to be having bilateral hips Charcot's arthropathy due to hereditary sensory autonomic neuropathy type 4. Other common causes of Charcot arthropathy were ruled out. The patient was conservatively managed and…
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- The Modern Treatment of Charcot Foot Arthropathy. [Journal Article]J Am Acad Orthop Surg. 2023 Jan 15; 31(2):71-79.JA
- The National Institute of Health now estimates that there are well over 37 million persons with diabetes in the United States alone, a number well over 11 per cent of our population. The associated multiple organ system disease is responsible for more than 327 billion dollars in direct and indirect medical costs and more than 140,000 lower extremity amputations yearly in the United States. Becaus…
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- Iatrogenic Ankle Charcot Neuropathic Arthropathy after Spinal Surgery: A Case Report and Literature Review. [Case Reports]
- Charcot neuropathic arthropathy is a relatively rare, chronic disease that leads to joint destruction and reduced quality of life of patients. Early diagnosis of Charcot arthropathy is essential for a good outcome. However, the diagnosis is often based on the clinical course and longitudinal follow-up of patients is required. Charcot arthropathy is suspected in patients with suggestive symptoms a…
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- Delayed Diagnosis of Bilateral Neuroarthropathy: Serious Impact on the Development of Charcot's Foot, a Case Report. [Case Reports]
- Charcot neuroarthropathy (CN) is a destructive complication of the joints in patients with diabetes and should be managed from the onset of the first symptoms to avoid joint deformity and the risk of amputating the affected joint. Here, we describe the case of a young 24-year-old patient living with type I diabetes who developed active bilateral CN in both tarsal joints. This case of neuroarthrop…
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- Impact of Sulfated Hyaluronan on Bone Metabolism in Diabetic Charcot Neuroarthropathy and Degenerative Arthritis. [Journal Article]
- Bone in diabetes mellitus is characterized by an altered microarchitecture caused by abnormal metabolism of bone cells. Together with diabetic neuropathy, this is associated with serious complications including impaired bone healing culminating in complicated fractures and dislocations, especially in the lower extremities, so-called Charcot neuroarthropathy (CN). The underlying mechanisms are not…
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- Neuropathic arthropathy of the wrist revealing a syringomyelia. [Case Reports]BMJ Case Rep. 2022 Nov 25; 15(11)BC
- Syringomyelia is uncommonly revealed by a neuropathic arthropathy (Charcot joint) and characterised by its slow progression with late neurological symptoms. In this particular field, neuropathic arthropathies mainly affect the shoulders and the elbows.We report a new case of neuropathic arthropathy of the wrist caused by syringomyelia, because of the rarity of this condition as well as its uncomm…
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- Arthrodesis in the Deformed Charcot Foot. [Review]Foot Ankle Clin. 2022 Dec; 27(4):835-846.FA
- Charcot neuroarthropathy (CN) is a systemic disease that causes fractures, dislocations, and deformities involving the foot and ankle, resulting in substantial risk of ulceration, infection, and function loss. Early recognition and prevention of collapsing foot and ankle are still the best options for the management of patients with diabetic CN. For a successful arthrodesis procedure, the princip…
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- Identification of Charcot Foot: A Case Report. [Case Reports]Nephrol Nurs J. 2022 Sep-Oct; 49(5):419-425.NN
- Neuropathy is a painful and potentially devastating complication of diabetes mellitus affecting many patients. Neuropathy can lead to foot ulcers, infections, and subsequent amputations. Nerve damage from peripheral neuropathy may lead to Charcot neuropathic osteoarthropathy, commonly known as Charcot foot. Flesh wounds and weakened bones causing microfractures of the foot and ankle may lead to f…
- Acute development of spinal lumbar synovial facet cyst within 1 week after lumbar decompression: illustrative case. [Journal Article]
- CONCLUSIONS: The literature reports postoperative spinal instability in up to one-third of patients with lumbar spinal stenosis and stable degenerative spondylolisthesis who undergo decompressive laminectomy. Close radiographic monitoring and early advanced imaging may be prudent in this patient population if they develop new postoperative neurological symptoms and show radiographic predictors of instability on preoperative imaging. Posterolateral spinal fusion with instrumentation should be considered in addition to lumbar decompression in this select group of patients who demonstrate radiographic predictors of delayed spinal instability if they are medically capable of tolerating a spinal fusion procedure.
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- Musculoskeletal complications in patients with diabetes mellitus. [Review]
- Musculoskeletal conditions are common in patients with diabetes. Several musculoskeletal disorders are viewed as chronic complications of diabetes because epidemiological studies have revealed high correlations between such complications and diabetes, but the pathophysiological links with diabetes remains unclear. Genetic predispositions, shared risk factors, microvascular impairments, progressiv…
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- The Association of Olfactory Impairment with Charcot Neuroarthropathy and Possible Links to Causation. [Journal Article]J Am Podiatr Med Assoc. 2022 Sep-Oct; 112(5)JA
- CONCLUSIONS: Microsomia is strongly associated with CN. This finding may be correlated to voltage-gated sodium 1.7 channel impairment and appears to be a candidate precursor for the development of CN.
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- Incidence of Complications and Risk Factors for Nonunion After Ankle Fracture in Diabetes Mellitus. [Journal Article]J Am Podiatr Med Assoc. 2022 Sep-Oct; 112(5)JA
- CONCLUSIONS: These results demonstrate risk factors for nonunions: dialysis, insulin use, and fracture severity after ankle fracture in patients with diabetes.
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- Current Concepts in Charcot Neuroarthropathy. [Editorial]Clin Podiatr Med Surg. 2022 10; 39(4):xv-xvi.CP
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- Plate Fixation in Midfoot and Ankle Charcot Neuroarthropathy. [Review]Clin Podiatr Med Surg. 2022 Oct; 39(4):675-693.CP
- Surgical reconstruction of Charcot arthropathy in the foot and ankle is extremely difficult. The fundamentals of reconstruction are necessary to provide adequate outcome. Removing and resecting the diseased bone is needed along with good anatomic alignment and rigid fixation. This reconstructive surgery is not only difficult from medical management point of view but also involves patient complian…
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- Circular Fixation in Charcot. [Review]Clin Podiatr Med Surg. 2022 Oct; 39(4):643-658.CP
- Static circular fixation is a valuable tool for patients with Charcot foot and ankle deformities. The versatility of circular fixators allows for dynamic adjustments over time and can allow for off-loading of flaps or ulcers. The circular fixator can be used as a primary fixation device in cases of osteomyelitis or to facilitate lengthening when a segmental bone defect exists such as loss of the …
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- The Use of Hexapod External Fixation in the Management of Charcot Foot and Ankle Deformities. [Review]Clin Podiatr Med Surg. 2022 Oct; 39(4):629-642.CP
- Charcot neuroarthropathy (CN) and its sequela is a disabling pathology in the foot and ankle. The 2-stage computer hexapod-assisted technique is an effective tool to address midfoot Charcot and ankle-hindfoot deformities to restore function and decrease the risk of amputation secondary to ulceration and infection. Although this is not the only technique available, it is an excellent option in cas…
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- Beaming the Charcot Foot. [Review]Clin Podiatr Med Surg. 2022 Oct; 39(4):605-627.CP
- The Charcot diabetic foot presents unique challenges to the podiatric surgeon in the quest to salvage the limb. This disorder is an intersection of prototypical metabolic diseases and neurodegenerative disorder. Furthermore, it can be considered a disease of bone and ligaments that is often complicated by peripheral vascular disease and serious deep infection. Presently, simplistic ablative surgi…
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- Surgical Optimization for Charcot Patients. [Review]Clin Podiatr Med Surg. 2022 Oct; 39(4):595-604.CP
- Reconstruction of the Charcot foot and ankle demonstrates significant challenges to the foot and ankle surgeon. At present, there is limited clear consensus on the best approach for preoperative optimization. The primary aim of Charcot reconstructions is to limit the risk of ulceration by providing a stable plantigrade foot allowing ambulation. The focus of this article is the discussion of modif…
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- Conservative Management of Charcot Neuroarthropathy. [Review]Clin Podiatr Med Surg. 2022 Oct; 39(4):585-594.CP
- Charcot can be a difficult clinical entity to diagnose in the acute phase, and clinicians should have a high clinical suspicion in neuropathic patients who present with erythema, edema, and warmth of the foot or ankle. Immobilization and nonweight-bearing should be immediately initiated when the diagnosis of Charcot has been made and patients should remain nonweight-bearing until the affected bon…
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- Nondiabetic Charcot Neuroarthropathy: Evaluation and Treatment. [Review]Clin Podiatr Med Surg. 2022 Oct; 39(4):571-584.CP
- There are many similarities between nondiabetic and diabetic Charcot neuroarthropathy (CN) but many of the underlying causes causing nondiabetic neuropathy and CN are associated with poor bone quality. Patient workup for nondiabetic CN should include the underlying cause of the neuropathy and optimization of bony healing, such as vitamin D supplementation and bisphosphonate or calcitonin administ…
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- Management of the Charcot Foot and Ankle: Nonreconstructive Surgery. [Review]Clin Podiatr Med Surg. 2022 Oct; 39(4):559-570.CP
- Diabetic neuroarthropathy is a complication of diabetes mellitus that results in instability of the foot, structural deformity, and soft-tissue breakdown. Commonly, midfoot collapse of the medial, lateral, or both longitudinal arches may result in increased plantar pressures and subsequent midfoot ulceration. Many of these wounds can be successfully managed with local wound care and off-loading; …
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- Bone Metabolism in Charcot. [Review]Clin Podiatr Med Surg. 2022 Oct; 39(4):543-557.CP
- Bone metabolism in the healthy, young adult is identified as a relatively stable process. Normal bone turnover is a dynamic state, which is conferred through intracellular signaling and complex cellular pathways. It has been well described in the literature that Charcot neuro-osteoarthropathy is a disease state, which is marked by intense bone turnover leading to structural collapse and dissoluti…
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- Diabetes Mellitus: An Overview in Relationship to Charcot Neuroarthropathy. [Review]Clin Podiatr Med Surg. 2022 Oct; 39(4):535-542.CP
- Diabetes mellitus with the lack of glycemic control increases risks for developing comorbidities affecting organ systems responsible for critical function. The development of diabetic neuropathy predisposes patients to the onset of Charcot neuroarthropathy (CN). There is significant complexity with treatment of diabetic-induced CN, which can have an often delayed or missed diagnosis. Supervision …
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- High rate of complications after corrective midfoot/subtalar arthrodesis and Achilles tendon lengthening in Charcot arthropathy type Sanders 2 and 3. [Journal Article]
- CONCLUSIONS: Operative treatment of Charcot arthropathy remains a surgical challenge with high complication rates. Surgical correction of equinus position has been highlighted for successful treatment but was not able to prevent complications in this study, which is demonstrated by the recurrent decrease of the calcaneal pitch in cases of reoperation. Therefore, as a conclusion of our results, our treatment algorithm changed towards primarily addressing the equinus malpositioning of the hindfoot by corrective arthrodesis of the hindfoot.
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- Camptodactyly-Arthropathy-Coxa Vara-Pericarditis Syndrome: The First Familial Case in China and Novel Mutations of the Proteoglycan 4 Gene. [Letter]J Rheumatol. 2022 12; 49(12):1400-1402.JR
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- Managing Acute Fore- and Midfoot Fractures in Patients with Diabetes. [Review]Foot Ankle Clin. 2022 Sep; 27(3):617-637.FA
- Few is investigated about the management of acute fore- and midfoot injuries in diabetics. With well controlled diabetes, indications and techniques are similar to non-diabetics. With poorly controlled diabetes, medical optimization should be exercised. Stable internal fixation in case of surgical treatment and prolonged offloading independent of the choice of treatment are advised. With manifest…
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- Nonoperative Treatment of Charcot Neuro-osteoarthropathy. [Review]Foot Ankle Clin. 2022 Sep; 27(3):595-616.FA
- Conservative treatment of Charcot neuro-osteoarthropathy (CN) aims to retain a stable, plantigrade, and ulcer-free foot, or to prevent progression of an already existing deformity. CN is treated with offloading in a total contact cast as long as CN activity is present. Transition to inactive CN is monitored by the resolution of clinical activity signs and by resolution of bony edema in MRI. Fitti…
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- Etiology, Epidemiology, and Outcomes of Managing Charcot Arthropathy. [Review]Foot Ankle Clin. 2022 Sep; 27(3):583-594.FA
- Surgical intervention for Charcot arthropathy is becoming more common; this is driven by an increased prevalence, better understanding of the cause, identifying patient risk factors that influence outcomes, and how to best optimize these. This article aims to summarize the cause of Charcot, look at the factors that influence the outcomes, and the financial cost of managing what is a very challeng…
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- NEMISIS: Neuropathic Minimally Invasive Surgeries. Charcot Midfoot Reconstruction, Surgical Technique, Pearls and Pitfalls. [Review]Foot Ankle Clin. 2022 Sep; 27(3):567-581.FA
- The last decade has seen a significant development in early surgical intervention for patients with or at risk of ulceration owing to deformity resulting from the sequalae of diabetic foot disease. Midfoot Charcot neuroarthropathy is the most common deformity; its correction is enabled by specialized surgical implants designed to maintain surgical corrections. There has also been an increasing nu…
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- Knee Reconstruction Using 3D-Printed Porous Tantalum Augment in the Treatment of Charcot Joint. [Case Reports]
- CONCLUSIONS: Through accurate surgical evaluation and preparation of 3D-printed porous tantalum implants, severe AORI classification type III Charcot joint disease can effectively restore the range of motion of the knee joint, the lower limb alignment, and finally achieve good functional results of walking without crutches.
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