Charcot Reconstruction: Outcomes in Patients With and Without Diabetes

Nicole K. Cates, Emily C. Wagler, Taylor J. Bunka, Tammer Elmarsafi, Eshetu Tefera, Paul J. Kim, George T. Liu, Karen K. Evans, John S. Steinberg, Christopher E. Attinger

Research output: Contribution to journalArticlepeer-review

Abstract

The objective of this study is to compare risk adjusted matched cohorts of Charcot neuroarthropathy patients who underwent osseous reconstruction with and without diabetes. The 2 groups were matched based on age, body mass index, hypertension, history of end-stage renal disease, and peripheral arterial disease. Bivariate analysis was performed for preoperative infection, location of Charcot breakdown, and post reconstruction outcomes, in patients with a minimum of 1 year follow-up period. Through bivariate analysis, presence of preoperative ulceration (p = .0499) was found to be statistically more likely in the patients with diabetes; whereas, delayed osseous union (p = .0050) and return to ambulation (p ≤ .0001) was statistically more likely in patients without diabetes. The nondiabetic Charcot patients were 17.6 folds more likely to return to ambulation (odds ratio [OR] 17.6 [95% confidence interval {CI} {3.5-87.6}]), and 16.4 folds more likely to have delayed union (OR 16.4 [95% CI {1.9-139.6)]). Subanalysis compared well-controlled diabetic and nondiabetic Charcot neuroarthropathy patients for same factors. Multivariate analysis, in the subanalysis, found return to ambulation was 15.1 times likely to occur in the nondiabetic CN cohort (OR 15.1 [95% CI 1.3-175.8]) compared to the well-controlled diabetic CN cohort.

Original languageEnglish (US)
Pages (from-to)1229-1233
Number of pages5
JournalJournal of Foot and Ankle Surgery
Volume59
Issue number6
DOIs
StatePublished - Nov 1 2020

Keywords

  • 3
  • Charcot neuroarthropathy
  • Retrospective Study
  • delayed osseous union
  • return to ambulation
  • well controlled diabetic patients

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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