TY - JOUR
T1 - Charcot Neuroarthropathy in Patients With Diabetes
T2 - An Updated Systematic Review of Surgical Management
AU - Schneekloth, Brian J.
AU - Lowery, Nicholas J.
AU - Wukich, Dane K.
N1 - Publisher Copyright:
© 2016 American College of Foot and Ankle Surgeons.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Charcot neuroarthropathy (CN) of the foot and ankle is a demanding clinical dilemma, and surgical management can be very complicated. Historically, the evidence guiding surgical management of CN has been small retrospective case series and expert opinions. The purpose of the present report was to provide a systematic review of studies published from 2009 to 2014 and to review the indications for surgery. A Medline search was performed, and a systematic review of studies discussing the surgical management of CN was undertaken. Thirty reports fit the inclusion criteria for our study, including 860 patients who had undergone a surgical procedure for the treatment of CN. The surgical procedures included amputation, arthrodesis, debridement of ulcers, drainage of infections, and exostectomy. The midfoot was addressed in 26.9% of cases, the hindfoot in 41.6%, and the ankle in 38.4%. Of the 30 studies, 24 were retrospective case series (level 4), 4 were controlled retrospective studies (level 3), and 2 were level II studies. The overall amputation rate was 8.9%. The quality of the published data on the surgical management of CN has improved during the past several years. Evidence concerning the timing of treatment and the use of different fixation methods remains inconclusive.
AB - Charcot neuroarthropathy (CN) of the foot and ankle is a demanding clinical dilemma, and surgical management can be very complicated. Historically, the evidence guiding surgical management of CN has been small retrospective case series and expert opinions. The purpose of the present report was to provide a systematic review of studies published from 2009 to 2014 and to review the indications for surgery. A Medline search was performed, and a systematic review of studies discussing the surgical management of CN was undertaken. Thirty reports fit the inclusion criteria for our study, including 860 patients who had undergone a surgical procedure for the treatment of CN. The surgical procedures included amputation, arthrodesis, debridement of ulcers, drainage of infections, and exostectomy. The midfoot was addressed in 26.9% of cases, the hindfoot in 41.6%, and the ankle in 38.4%. Of the 30 studies, 24 were retrospective case series (level 4), 4 were controlled retrospective studies (level 3), and 2 were level II studies. The overall amputation rate was 8.9%. The quality of the published data on the surgical management of CN has improved during the past several years. Evidence concerning the timing of treatment and the use of different fixation methods remains inconclusive.
KW - 2
KW - CN
KW - Charcot
KW - Charcot neuropathy
KW - Level of Evidence
KW - Medline
KW - Surgical management
UR - http://www.scopus.com/inward/record.url?scp=84955241077&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84955241077&partnerID=8YFLogxK
U2 - 10.1053/j.jfas.2015.12.001
DO - 10.1053/j.jfas.2015.12.001
M3 - Review article
C2 - 26810129
AN - SCOPUS:84955241077
SN - 1067-2516
VL - 55
SP - 586
EP - 590
JO - Journal of Foot and Ankle Surgery
JF - Journal of Foot and Ankle Surgery
IS - 3
ER -