Weight-Bearing Intensity Produces Charcot Deformity in Injured Neuropathic Feet in Diabetes

Kimmerle, Renate; Chantelau, E

doi:10.1055/s-2007-970578

Cited by 40 publications

(42 citation statements)

References 21 publications

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“…The number off recurrent cases was as high as 33%. A possible explanation for the long off-loading periods (and high recurrence) might be the time elapsed from the first sign of CA to the time of off-loading, as reported by Kimmerle (Kimmerle & Chantelau, 2007). Patients with the shortest period between onset and treatment had the best outcome (Chantelau, 2005).…”

Section: Discussionmentioning

confidence: 94%

Duration of off-loading and recurrence rate in Charcot osteo-arthropathy treated with less restrictive regimen with removable walker

Christensen

Gade-Rasmussen

Pedersen

et al. 2012

Journal of Diabetes and its Complications

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Section: Discussionmentioning

confidence: 94%

Duration of off-loading and recurrence rate in Charcot osteo-arthropathy treated with less restrictive regimen with removable walker

Christensen

Gade-Rasmussen

Pedersen

et al. 2012

Journal of Diabetes and its Complications

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“…These injuries are symptomatic only by pedal swelling, hyperthermia, and lymphedema [16], while pain is merely absent due to the underlying neuropathy. Since any skeletal healing is impeded by infection, movement and pressure, EESC in the foot will deteriorate unless these are eliminated [17,18]. Hence, in active-stage Charcot foot, immobilization and offloading causes posttraumatic EESC to decline [2–5].…”

Section: Introductionmentioning

confidence: 99%

Follow up of MRI bone marrow edema in the treated diabetic Charcot foot – a review of patient charts

Chantelau

Antoniou

Zweck

et al. 2018

Diabetic Foot & Ankle

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Background: Ill-defined areas of water-like signal on bone magnetic resonance imaging (MRI), characterized as bone marrow edema or edema-equivalent signal-changes (EESC), is a hallmark of active-stage pedal neuro-osteoarthropathy (Charcot foot) in painless diabetic neuropathy, and is accompanied by local soft-tissue edema and hyperthermia. The longitudinal effects on EESC of treating the foot in a walking cast were elucidated by reviewing consecutive cases of a diabetic foot clinic. Study design: Retrospective observational study, chart review Material and methods: Cases with active-stage Charcot foot were considered, in whom written reports on baseline and follow-up MRI studies were available for assessment. Only cases without concomitant infection or skin ulcer were chosen, in whom both was documented, onset of symptomatic foot swelling and patient compliance with cast treatment. Results: From 1994 to 2017, 45 consecutive cases in 37 patients were retrieved, with 95 MRI follow-up studies (1–6 per case, average interval between studies 13 weeks). Decreasing EESC was documented in 66/95 (69%) follow-up studies. However, 29/95 (31%) studies revealed temporarily increasing, migrating or stagnating EESC. Conclusion: EESC on MRI disappear in response to prolonged offloading and immobilizing treatment; however, physiologic as well as pathologic fluctuations of posttraumatic EESC have to be considered when interpreting the MR images. Conventional MRI is useful for surveillance of active-stage Charcot foot recovery.

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“…In particular, unstable deformities in these frequently obese patients are difficult to brace with a high inherent risk of ulceration in the insensate feet [19,21]. Late institution of immobilization and unloading runs a high risk of permanent deformity after healing [6,14]. An underlying fixed deformity or osseous prominence is one of the main reasons for recurrence of ulceration [35].…”

Section: Introductionmentioning

confidence: 99%

Should One Consider Primary Surgical Reconstruction in Charcot Arthropathy of the Feet?

Mittlmeier

Klaue

Haar

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Charcot neuroosteoarthropathy of the feet can induce severe instability and deformity with subsequent plantar ulceration leading to substantial disability or even amputation. Traditionally, nonoperative treatment is regarded as the primary option of treatment while surgery is restricted to treating complications or failure of nonoperative treatment. Failed nonoperative treatment essentially prolongs treatment period. We retrospectively reviewed 22 patients (26 feet) with midfoot (n = 9) or hindfoot (n = 17) neuropathy who underwent primary surgical reconstruction and reorientation arthrodesis due to manifest instability, nonplantigrade foot position, and deformity with overt (n = 8) or what we judged was impending ulceration (n = 9). The minimum followup was 0.5 years (mean, 2.7 years; range 0.5-7 years). All eight ulcers healed without recurrence of ulceration or manifestation of new ulcers during the followup period. We observed complications leading to further surgery in nine patients: five with perioperative hematoma and four with instability.

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Weight-Bearing Intensity Produces Charcot Deformity in Injured Neuropathic Feet in Diabetes

Cited by 40 publications

References 21 publications

Duration of off-loading and recurrence rate in Charcot osteo-arthropathy treated with less restrictive regimen with removable walker

Duration of off-loading and recurrence rate in Charcot osteo-arthropathy treated with less restrictive regimen with removable walker

Follow up of MRI bone marrow edema in the treated diabetic Charcot foot – a review of patient charts

Should One Consider Primary Surgical Reconstruction in Charcot Arthropathy of the Feet?

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