Success and Survivorship Following Charcot Reconstruction: A Review of 151 Cases
Section snippets
Patients and Methods
This study was carried out within Kaiser Permanente Northern California (KPNC), an integrated healthcare system, and approved by its Institutional Review Board. Electronic medical records (EMR) were retrospectively reviewed for patients with CN who subsequently underwent reconstruction surgery at a KPNC facility between January 2009 and December 2014. Patients were identified using International Classification of Diseases-9 (ICD-9), International Classification of Disesases-10 (ICD-10), and
Subjects
The cohort consisted of 151 patients who underwent foot or ankle CN reconstruction in a 5-year (2009-2014) period within KPNC. The mean age of the cohort at the time of CN diagnosis was 55.1 ± 8.3 (range 29.0-78.0) years. The mean age at the time of reconstruction was 56.0 ± 8.5 (range 29.0-78.0) years. The population was 43.1% (65/151) female. The majority of the cohort were non-Hispanic White (68.2%), followed by Hispanic (21.2%). The mean BMI was 35.1 ± 7.6 (range 20.9-56.0) kg/m2. Almost
Discussion
While the devastating effects of CN are well known among the foot and ankle surgical community, there are still many unknowns pertaining to the treatment of these patients. In the past, conservative treatment via total contact casting and offloading was considered the gold standard, whereas more recently surgical intervention has become favorable. From a surgical standpoint, there are 2 general approaches: a basic exostectomy where bony plantar prominences are resected or a more complex
Acknowledgment
The authors would like to extend our gratitude to the Kaiser Permanente Division of Research and the Kaiser Permanente Department of Graduate Medical Education for their support.
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Cited by (4)
Considerations in Charcot Reconstruction
2024, Clinics in Podiatric Medicine and SurgerySurgical management of Charcot foot – The advancements over the past decade
2023, Journal of Clinical Orthopaedics and TraumaPlate Fixation in Midfoot and Ankle Charcot Neuroarthropathy
2022, Clinics in Podiatric Medicine and SurgeryCitation Excerpt :When nonoperative care has failed and the patient presents with wounds, infections, and instability, surgical intervention is warranted. Studies have demonstrated compromised successes and increased complications in CN reconstruction alongside patient comorbidities.2,9 McCann and colleagues9 noted in 151 cases that those who underwent ankle or subtalar reconstruction were 70% less likely to return to walking than those undergoing medial column reconstruction.
Financial Disclosure: None reported.
Conflict of Interest: None reported.