CME OnDemand: 2022 AOFAS Annual Meeting-A 5-Year Follow-Up of Neuropathic Minimally Invasive Surgeries with Superconstructs for Mid-Foot Charcot Deformity

A 5-Year Follow-Up of Neuropathic Minimally Invasive Surgeries with Superconstructs for Mid-Foot Charcot Deformity

Pdf Summary

Professor Ros Miller, from NHS Lanarkshire Universities Hospitals and Glasgow Caledonian University in Scotland, conducted a 5-year follow-up study on Neuropathic Minimally Invasive Surgeries (MIS) for Mid-foot Charcot Deformity. Charcot Neuroarthropathy is a condition characterized by swollen, hot, and red feet, along with painless deformities and poor fitting shoes. The condition is caused by mechanical overload and can result in the sudden collapse of the arch.<br /><br />The goal of MIS surgery is to prevent further ulceration, improve patient mobility, and correct deformities. Inclusion criteria for surgery includes patients with confirmed Charcot Neuroarthropathy, no active osteomyelitis or infections, reasonable glycemic control, and optimization by a multidisciplinary team.<br /><br />The study included 19 patients over 5 years, with 11 males and 8 females. The MIS technique involved percutaneous instruments, low-speed saline irrigation, and specialized instruments and burrs. Correction of deformities was done through osteotomy and fixation with cannulated screws, beams, and bolts. Implant failure and deep-seated infections were observed in some cases, resulting in revisions and amputations.<br /><br />New cases of Charcot were also observed, both in the same foot and in the contralateral foot within 6 months of the index procedure. The study reported mortality rates due to sepsis, diabetic renal disease, cancer, and respiratory disease.<br /><br />The conclusion of the study suggests that MIS surgery has the potential to correct deformities and minimize the risk of deep-seated infections in high-risk patients with Charcot Neuroarthropathy. However, the impact on reducing mortality rates is difficult to predict due to the co-morbidities of these patients.<br /><br />Contact information for Professor Ros Miller is provided for further inquiries.

Asset Subtitle

Roslyn Miller, MB, ChB, FRCS(Ed), FRCS(Tr&Oth)

Keywords

Charcot Neuroarthropathy

MIS surgery

deformity correction

deep-seated infections

osteomyelitis

multidisciplinary team

implant failure

amputations

mortality rates

high-risk patients