Medium- and Long-term Outcomes of Surgical Reconstruction in Acute Charcot Neuroarthropathy

Description

In this presentation, Amit Patel, a foot and ankle fellow at King's College Hospital, discusses the challenges of managing acute Charcot neuroarthropathy, particularly in diabetic patients. He outlines the typical initial treatment approach, which includes non-weightbearing methods like total-contact casts, to promote bony consolidation. However, he notes that some patients may present with significant deformity, instability, and ulceration, indicating a 'foot at risk' that may require early surgical intervention to prevent amputation.



Over an eight-year period, Patel's team collected data from 25 patients, identifying 26 affected feet. In this cohort, 12 patients had infections that were addressed with antibiotics before undergoing definitive surgery, while the remaining 14 received immediate reconstruction. The results showed that, with an average follow-up of 45 months, there was a high rate of limb salvage and eradication of ulceration, especially among those previously deemed at high risk for amputation. The study revealed that hindfoot reconstructions had a greater likelihood of achieving bony union compared to midfoot procedures.



Patel emphasizes the importance of early surgical intervention in these complex cases, suggesting that successful outcomes are feasible, even in patients who had previously been informed that amputation was the most likely outcome.

DOI: 10.1302/3114-210276

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