5 year retrospective follow-up of new cases of Charcot neuroarthropathy—A single centre experience

• The recommended gold standard treatment for a Charcot joint is immobilisation.
• Few data describe the history of Charcot joints in a total contact plaster cast.
• This data represents a large single centre experience of 50 consecutive Charcot cases.
• Time to healing was not different between total contact cast and removable boot.
• Despite optimal treatment with offloading and immobilisation, 35% required recasting.

BackgroundFew data describe the natural history of Charcot neuroarthropathy treated with a total contact plaster cast (TCC).MethodsA 5 year retrospective analysis of 50 patients presenting with an acute CN, Assessing time to clinical resolution into appropriate footwear and assessing if initial immobilisation device influenced resolution time.ResultsDuring the study period 42 patients (84%) of patients went into remission, 2 died during their treatment, 4 had major amputations, in 2 patients treatment was ongoing. 36 patients were treated with combination offloading devices, 6 were treated with one modality only. Median time to resolution for patients initially treated with a TCC was not significantly shorter than for those treated with a removable below knee boot. 34.9% required re-casting due to clinical deterioration in the removable device.ConclusionsMore precise measures of resolution of CN are needed to assess the impact of initial treatment modality on time to resolution.