Charcot arthropathy of the knee after unsuccessful spinal stenosis surgery: A case report

Cıvan, Melih; Yazıcıoğlu, Önder; Çakmak, Mehmet; Akgül, Turgut

doi:10.1016/j.ijscr.2017.04.023

Cited by 6 publications

(14 citation statements)

References 12 publications

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“…Patient presented with chronic polyneuropathy and total sensorineural loss following a failed spinal stenosis surgery. Reprinted with permission from Cıvan and colleagues . ( B , C ) X‐ray of the knee joints of Eloesser's cat showing a frontal projection of the control side ( B ) and lateral view of the affected side ( C ); the affected knee was subjected to an acute thermocautery trauma following sensory posterior root resection as depicted in D (scissors) and subsequently developed deformity and grating of joint surfaces within 3 weeks.…”

Section: Development Of a Unified Theory For Nerves In Bonementioning

confidence: 99%

“…Reprinted with permission from Cıvan and colleagues. (182) (B, C) X-ray of the knee joints of Eloesser's cat showing a frontal projection of the control side (B) and lateral view of the affected side (C); the affected knee was subjected to an acute thermocautery trauma following sensory posterior root resection as depicted in D (scissors) and subsequently developed deformity and grating of joint surfaces within CGRP and SP are prevalent in bones across vertebrate species. (5,7,10,(15)(16)(17) These exist as both small unmyelinated (0.2 to 1.5 µm) or medium myelinated fibers (1 to 5 µm).…”

Section: Sensory Nerves In Bonementioning

confidence: 99%

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Nerves in Bone: Evolving Concepts in Pain and Anabolism

Brazill

Beeve

Craft

et al. 2019

J of Bone & Mineral Res

116

150

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The innervation of bone has been described for centuries, and our understanding of its function has rapidly evolved over the past several decades to encompass roles of subtype‐specific neurons in skeletal homeostasis. Current research has been largely focused on the distribution and function of specific neuronal populations within bone, as well as their cellular and molecular relationships with target cells in the bone microenvironment. This review provides a historical perspective of the field of skeletal neurobiology that highlights the diverse yet interconnected nature of nerves and skeletal health, particularly in the context of bone anabolism and pain. We explore what is known regarding the neuronal subtypes found in the skeleton, their distribution within bone compartments, and their central projection pathways. This neuroskeletal map then serves as a foundation for a comprehensive discussion of the neural control of skeletal development, homeostasis, repair, and bone pain. Active synthesis of this research recently led to the first biotherapeutic success story in the field. Specifically, the ongoing clinical trials of anti‐nerve growth factor therapeutics have been optimized to titrated doses that effectively alleviate pain while maintaining bone and joint health. Continued collaborations between neuroscientists and bone biologists are needed to build on this progress, leading to a more complete understanding of neural regulation of the skeleton and development of novel therapeutics. © 2019 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals, Inc.

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Section: Development Of a Unified Theory For Nerves In Bonementioning

confidence: 99%

Section: Sensory Nerves In Bonementioning

confidence: 99%

Nerves in Bone: Evolving Concepts in Pain and Anabolism

Brazill

Beeve

Craft

et al. 2019

J of Bone & Mineral Res

116

150

View full text Add to dashboard Cite

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“…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 ]. For patients presenting with these features, osteomyelitis, septic arthritis, pseudogout are important differentials, and 13 studies involving 16 patients performed joint aspiration studies to exclude them [ 12 , 13 , 16 , 18 , 23 , 25 , 27 , 39 , 42 , 45 , 49 , 51 , 58 ].…”

Section: Resultsmentioning

confidence: 99%

“…Nevertheless, 5 studies involving 14 patients reported no sensory deficits [12,15,31,35,56]. Nerve conduction studies, performed with the monofilament test or EMG studies, produced pathological results such as chronic polyneuropathy with sensorineural loss [20,50], and showed decreased nerve conduction velocity [40,61]. Two studies involving one patient each performed biopsy of the sural nerve, and reported loss of myelinated fibres [40,58].…”

Section: Knee Deformitiesmentioning

confidence: 99%

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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“…Es gibt zwar eine Reihe weiterer Publikationen zur CN des Kniegelenkes, diese beschreiben aber jeweils nur Casereports zur Osteosynthese oder Endoprothetik bei CN des Kniegelenkes[12][13][14][15][16][17] oder Casereports zur CN des Kniegelenkes als seltene Komplikationen anderer Erkrankungen z. B. nach Wirbelsäuleninterventionen[18].Die Charcot Neuroarthropathie des Kniegelenkes soll nun an einem klinischen Fallbeispiel dargestellt werden. Das schriftliche Einverständnis nach Aufklärung liegt vor und die Deklaration von Helsinki wird eingehalten.FallberichtEs handelt sich um einen 58-jährigen Patienten, der mit einem seit 7 Wochen geschwollenen Knie ohne Trauma zur Abklärung der Grunderkrankung aus einer benachbarten Klinik vorgestellt wurde (▶ abb.…”

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Die Charcot Neuroarthropathie des Kniegelenkes

Illgner

2020

Aktuelle Rheumatologie

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Zusammenfassung Hintergrund Während die Charcot Neuroarthropathie (CN) des Fußes immer mehr Aufmerksamkeit gewinnt, wird die CN des Knies kaum beachtet. Zwar erschienen in den letzten Jahren einige Publikationen zu CN des Knies, es handelte sich aber fast ausschließlich um Einzelfallbeschreibungen und meist dann auch nur zur endoprothetischen Versorgung. Es existieren nur 2 systematische Beschreibungen der Erkrankung. Ergebnisse Es wird an Hand eines Patienten nun der Krankheitsverlauf und die Charakteristika der CN am Knie detailiert sowie die Therapieoptionen dargestellt und in den Kontext einer vorangegangenen Publikation mit 3 Patienten mit CN des Kniegelenkes gesetzt. Die CN des Kniegelenkes zeigte die gleiche schubartige und stadienhafte Klinik analog zur CN des Fußes. Die Anwendung derselben Therapieprinzipien wie bei der CN des Fußes (sofortige Immobilisierung und Offloading) führte in allen Fällen zu einer schnellen Überführung in ein inaktives Stadium mit Konsolidierung des Befundes, sodass alle Patienten mittels Orthesen und ohne Operation wieder gehfähig wurden. Es handelte sich bei allen Patienten um Diabetiker mit multiplen Komplikationen (3x Diabetes Typ I, 1x Diabetes Typ 2), alle litten an einer stark fortgeschrittenen Polyneuropathie der unteren Extremität. Schlußfolgerung Die CN des Kniegelenkes stellt eine schwere Komplikation bei Polyneuropathie dar und darf nicht übersehen werden. Dieselben Diagnose- und Behandlungskriterien wie bei der CN des Fußes führten zum Erhalt von Knie und Gehfähigkeit.

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Charcot arthropathy of the knee after unsuccessful spinal stenosis surgery: A case report

Cited by 6 publications

References 12 publications

Nerves in Bone: Evolving Concepts in Pain and Anabolism

Nerves in Bone: Evolving Concepts in Pain and Anabolism

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

Die Charcot Neuroarthropathie des Kniegelenkes

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