Charcot arthropathy in the diabetic patient. A review of current concepts
DOI:
https://doi.org/10.1016/j.rccot.2020.04.013Keywords:
diabetes mellitus, Charcot arthropathy, diabetic foot, surgical treatment, amputationAbstract
Charcot Neuroarthropathy (NA), despite being documented for close to 120 years, it is only in the last two decades that its comprehension has increased, given the understanding of causality and the proportional relationship with the increase in the prevalence of diabetes. This generates important challenges in its treatment, currently focused on the a priori preservation of the limb, given the relationship of amputation with increased cardiac output, loss of quality of life, depression, infection at higher levels of the limb, increased long-term costs to the health system, loss of quality of life, and high association with 5-year mortality, which is even higher than the prevalence of cancers, such as breast and colon. Although the diagnosis is predominantly clinical, the support in blood chemistry, in conventional imaging and / or magnetic resonance imaging, PET / CT, help to differentiate the process per se, as well as the possible relationship with underlying infection. The advent of reconstructive surgeries and their technical compression are providing clues to achieve the aim of preserving the limb, and rehabilitate diabetic patients. A review of the topic is presented herein.
Evidence Level: IV
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