Charcot neuroarthropathy treated by arthrodesis with multiaxial screw superconstructs and Caldiño method
Keywords:
Charcot neuroarthropathy, diabetes mellitus, arthrodesis, superconstructsAbstract
Introduction: Charcot neuroarthropathy is a chronic disease that destroys the bone and joint structure of patients with peripheral neuropathy. It can be painful or asymptomatic, and it is observed in the extremities with loss of sensory innervation.
Objective: To determine the functional results, complications, and satisfaction in patients diagnosed with Charcot neuroarthropathy in stages II and III of Eichenholtz, treated using Caldiño method and arthrodesis with multiaxial screw superconstructs.
Methods: A retrospective, descriptive study was conducted on 16 patients with Charcot neuroarthropathy, treated from January 2023 to January 2024 using Caldiño method and hindfoot and midfoot arthrodesis with multiaxial screw superconstructs. Functionality was analyzed using AOFAS scale, and complications and satisfaction were evaluated using EVA scale. The treatment method used was described.
Results: The mean age was 52.2 years. Type 2 diabetes mellitus was identified as the etiology in 87.5 %. Panastragalodesis was performed in 68.8 % and triple arthrodesis in 31.2 %. Initial functionality was 27.69 points on AOFAS scale and at one year it reached 79.5 points with an average improvement of 51.81. Complications occurred in 43.75 % (7/16) of patients: superficial infections in 71.42 % and delayed healing of surgical wounds in 28.58 %.
Conclusions: Treatment of Charcot neuroarthropathy by arthrodesis with multiaxial screw superconstructs and Caldiño method restores functional indices in patients and it allows independent walking with low pain indices at 12 months. This procedure and surgical technique can be used in disabling hindfoot and midfoot deformities as it has proven effective in restoring functionality and patient satisfaction.
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1. Dardari D. An overview of Charcot’s neuroarthropathy. J Clin Transl Endocrinol. 2020;22(100239):100239. DOI: http://dx.doi.org/10.1016/j.jcte.2020.100239
2. Gooday C, Hardeman W, Poland F, Woodburn J, Dhatariya K. Controversies in the management of active Charcot neuroarthropathy. Ther Adv Endocrinol Metab. 2023;14:20420188231160406. DOI: http://dx.doi.org/10.1177/20420188231160406
3. Svendsen OL, Rabe OC, Winther-Jensen M, Allin KH. How common is the rare Charcot foot in patients with diabetes? Diabe Car. 2021;44(4):e62-3. DOI: http://dx.doi.org/10.2337/dc20-2590
4. Schoots IG, Slim FJ, Busch-Westbroek TE, Maas M. Neuro-osteoarthropathy of the foot-radiologist: friend or foe? Semin Musculoskelet Radiol. 2010;14(3):365-76. DOI: https://doi.org/10.1055/s-0030-1254525
5. Caldiño-Lozada I, Rojas-Osorio D, Esperón-Hernández R. Artropatía de Charcot: un método para su tratamiento. Seguimiento a cinco años. Acta Ortop Mex. 2017 [acceso 09/08/2024];31(2):67-74. Disponible en: https://www.medigraphic.com/pdfs/ortope/or-2017/or172b.pdf
6. Gong JC, Zhou BH, Tao X, Yuan ChS, Tan KL. Tibiotalocalcaneal arthrodesis with headless compression screws. J Orthop Surg Res. 2016;11:91. DOI: https://doi.org/10.1186/s13018-016-0425-7
7. Caldiño I. Casting a path to improved outcomes: The crucial role of total contact corrective casts in Charcot neuroarthropathy treatment. Great Bri J Press. 2023 [acceso 09/08/2024];23(9):9-15. Disponible en: https://journalspress.com/total-contact-corrective-cast-key-in-the-treatment-of-patients-with-charcot-neuroarthropathy/
8. Rana B, Patel S. Results of Ankle and Hind foot arthrodesis in Diabetic Charcot Neuroarthropathy - A retro-spective analysis of 44 patients. J Clin Orthop Trauma. 2021;23(101637):101637. DOI: http://dx.doi.org/10.1016/j.jcot.2021.101637
9. Medina GR. Fisiopatología de la neuroartropatía de Charcot. Ortho-tips. 2019 [acceso 02/01/2025];15(3):146-52. Disponible en: https://www.medigraphic.com/pdfs/orthotips/ot-2019/ot193b.pdf
10. Shazadeh Safavi P, Jupiter DC, Panchbhavi V. A Systematic review of current surgical interventions for Charcot neuroarthropathy of the midfoot. J Foot Ankle Surg. 2017;56(6):1249-52. DOI: http://dx.doi.org/10.1053/j.jfas.2017.06.011
11. Baravarian B, Van Gils CC. Arthrodesis of the Charcot foot and ankle. Clin Podiatr Med Surg. 2004;21(2):271-89. DOI: http://dx.doi.org/10.1016/j.cpm.2004.01.007
12. Sundararajan SR, Srikanth KP, Nagaraja HS, Rajasekaran S. Effectiveness of hindfoot arthrodesis by stable internal fixation in various eichenholtz stages of neuropathic ankle arthropathy. J Foot Ankle Surg. 2017;56(2):282-6. DOI: http://dx.doi.org/10.1053/j.jfas.2016.11.002
13. Regauer M, Grasegger V, Fürmetz J, Kussmaul AC, Böcker W, Ehrnthaller C. High rate of complications after corrective midfoot/subtalar arthrodesis and Achilles tendon lengthening in Charcot arthropathy type Sanders 2 and 3. Int Orthop. 2023;47(1):141-50. DOI: http://dx.doi.org/10.1007/s00264-022-05567-y
14. López-Gavito EG, Pasache-Lozano RP, Parra-Téllez EP. Evaluación funcional y de calidad de vida en el seguimiento de pacientes con artropatía de Charcot tratados mediante artrodesis de tobillo con clavo centromedular retrógrado bloqueado. Acta Ortop Mex. 2023;37(1):25-9. DOI: http://dx.doi.org/10.35366/112810
15. Rastegar S, Teymouri M, Sabaghi J. Association between the procedure of tibiotalocalcaneal arthrodesis by hindfoot nailing and quality of life in Charcot’s joint. J Orthop Surg Res. 2024;19:332. DOI: https://doi.org/10.1186/s13018-024-04787-9
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Copyright (c) 2025 Juan Crisostomo De León Galindo, Itzel Caldiño Lozada, Ramón Esperón Hernández
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