Allograft bone transplantation for neuropathic arthropathy of the knee associated with type 1 diabetes mellitus

Date, Hiroyuki; Hayakawa, Kazue; Yamada, Harumoto

doi:10.1016/j.knee.2012.06.002

Cited by 4 publications

(11 citation statements)

References 19 publications

(25 reference statements)

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“…Among the 27 studies (68 patients) that reported time from symptom onset to diagnosis, on average, patients were diagnosed with CK 50.5 months after their symptoms occurred, which could be non-specific such as ambulatory disturbance, knee tenderness, gradual development of joint instability, with one patient diagnosed 20 years after the onset of walking difficulty [ 47 ]. Specific triggers are sometimes described, for example a misstep whilst hiking on the Appalachian Trail [ 60 ], or traumatic incidents [ 15 , 23 , 25 , 35 , 43 ]. Pain Twenty-one studies involving 52 patients described a degree of pain and tenderness as a presenting complaint [ 7 , 16 , 17 , 19 – 24 , 28 , 35 , 37 , 38 , 44 , 47 , 54 , 57 – 61 ] especially during movement [ 21 , 37 , 57 ].…”

Section: Resultsmentioning

confidence: 99%

“…As proposed by Eichenholtz, CK is divided into 3 phases, development, coalescence, reconstruction. 68 patients in 34 studies presented during the development or coalescence phase, and hence presented with swelling, joint effusion, erythema, and knee ballottement [ 5 , 6 , 8 , 12 , 13 , 15 – 17 , 19 – 23 , 25 – 29 , 35 – 37 , 39 , 40 , 42 – 46 , 48 , 49 , 52 , 53 , 59 , 62 ]. One patient presented without oedema or erythema upon inspection, and radiographs confirmed that this patient’s CK was already beyond the fragmentation and coalescence stage at diagnosis [ 50 ].…”

Section: Resultsmentioning

confidence: 99%

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Charcot knee — presentation, diagnosis, management — a scoping review

Zhang

Thahir

et al. 2021

Clin Rheumatol

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Background Charcot arthropathy is a progressive, non-infectious, destructive inflammatory process. Charcot arthropathy of the knee (CK) is rare and diagnosis is often delayed, resulting in detrimental outcomes. This scoping review aims to investigate the literature on CK, present the pathognomonic features of CK to aid early diagnosis, and suggest gaps in the literature for future research. Methods A systematic search of PubMed, EMBASE, Web of Science for literature relevant to CK was performed. Primary studies such as case reports, case series, retrospective studies were included. Review articles and animal studies were excluded. Results Of the 513 results, 58 were included in qualitative synthesis. Average time from symptom onset to CK diagnosis was 50.5 months. Eighteen and twenty-one studies included patients who had diabetes mellitus and syphilis, respectively. Twenty-one studies reported pain as a presenting complaint, but the degree of pain didn’t correspond with the level of destruction. Oedema and joint effusion were noticed in 34 studies. Twenty-nine studies reported lower limb hypoesthesia and 17 studies reported decreased tendon reflex. Twenty-eight studies reported initial conservative treatment, often in a knee brace with minimal weight bearing, 9 of which needed subsequent surgical management. Twelve studies utilised arthrodesis, with fracture at the intramedullary nail entry site being the most common complication. Twenty-four studies utilised TKA. Conclusion The literature on CK remains sparse, with most publications being case reports. Given that CK dramatically reduces quality of life, increases morbidity of patients, there is need for more literature on evidence-based options for early diagnoses and management.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Charcot knee — presentation, diagnosis, management — a scoping review

Zhang

Thahir

et al. 2021

Clin Rheumatol

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“…L'aspect de fracture-enfoncement du plateau tibial interne semble caractéristique dans ce contexte d'un genou de Charcot [1,[3][4][5][6]. La durée du diabète et un déséquilibre profond semblent être des facteurs favorisants [1,[3][4][5][6].…”

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“…La durée du diabète et un déséquilibre profond semblent être des facteurs favorisants [1,[3][4][5][6]. Le caractère indolore des lésions et la rareté de cette localisation peuvent être à l'origine d'un retard de prise en charge.…”

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“…L'arthrodèse reste le traitement de référence, mais implique un retentissement fonctionnel difficile à envisager pour un patient jeune. L'arthroplastie semble efficace [2,3,5,6], mais présente un risque de complications, les diabétiques ayant un os fragile et une instabilité ligamentaire. Enfin, l'ostéotomie correctrice du cal vicieux associée à une greffe osseuse est l'alternative chirurgicale ayant le meilleur rapport bénéfice-risque chez un patient jeune, comme dans le cas rapporté ici [6].…”

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