Tibiocalcaneal arthrodesis for the treatment of advanced stage Charcot arthropathy: Clinical and radiological outcome analysis of patients with diabetes mellitus followed for at least 2 years

Öz

Aim: Charcot arthropathy (CA) described by Jean-Martin Charcot is a noninfectious degenerative and destructive process of the bones, joints and soft tissues in the area of the foot and ankle which associated with peripheral neuropathy. The purpose of this study was to evaluate the outcomes of tibiocalcaneal fusion using a retrograde hind foot ankle nail fixation system in 5 Charcot patients.

Material and Methods: Between 2014 and 2016, a total of 5 patients (4 women and 1 man) who underwent tibiocalcaneal arthrodesis for the treatment of advanced CA (Brodsky type 4) were evaluated. The demographic characteristics, clinical (AOFAS scores, early and late complications) and radiological (time for a union) evaluation parameters and patient satisfaction were analyzed before and after surgery.

Results: The mean preoperative AOFAS score was 64.8 ± 8.55 and mean postoperative score was 82.6 ± 12.99. The difference between preoperative AOFAS and postoperative AOFAS scores were statistically significant. During the clinical and radiological follow-up; infection, implant failure, and peri-implant fractures were checked and complications were recorded.

Conclusion: AOFAS scores were recorded before surgery after full weight bearing and it was found that talocalcaneal arthrodesis which was achieved with intramedullary nailing significantly increased AOFAS score compared to the preoperative AOFAS score.

Anahtar Kelimeler

• Charcot arthropathy
• tibiocalcaneal arthrodesis
• limb-salvage
• nail fixation
• diabetes mellitus

İleri evre Charcot artropatisinin tedavisi için tibiokalkaneal artrodez: Diyabetes mellituslu hastaların en az 2 yıllık takibi ile klinik ve radyolojik sonuç analizi

Öz

Amaç: Jean-Martin Charcot tarafından tanımlanan Charcotartropatisi, periferiknöropati ile ilişkili ayak ve ayak bileği bölgesindeki kemiklerin, eklemlerin ve yumuşak dokuların enfeksiyöz olmayan dejeneratif bir hastalığıdır. Bu çalışmanın amacı, 5 Charcotartropati hastasında retrograd arka ayak bileği fiksasyon sistemi kullanılarak yapılan tibiokalkaneal füzyonun sonuçlarını değerlendirmektir.

Gereç ve Yöntemler: 2014-2016 yılları arasında ileri Charcotartropati tedavisi için tibiokalkanealartrodez uygulanan 5 hasta (4 kadın ve 1 erkek) değerlendirildi. Ameliyat öncesi ve sonrası demografik özellikler, klinik (AOFAS skorları, erken ve geç komplikasyonlar) ve radyolojik (birleşme zamanı) değerlendirme parametreleri ve hasta memnuniyeti analiz edildi.

Bulgular: Ameliyat öncesi ortalama AOFAS skoru 64.8 ± 8.55 ve ortalama ameliyat sonrası skor 82.6 ± 12.99 idi. Ameliyat öncesi AOFAS ve ameliyat sonrası AOFAS skorları arasındaki fark istatistiksel olarak anlamlı bulundu. Klinik ve radyolojik takip sırasında; enfeksiyon, implant yetmezliği ve implant çevresi kırıklar ve komplikasyonlar kaydedildi.

Sonuç: AOFAS skorları ameliyat öncesi kaydedilmiş ve intramedüller çivileme ile elde edilen talokalkanealartrodezin AOFAS skorunu preoperatif AOFAS skoruna göre anlamlı derecede artırdığı bulunmuştur.

Anahtar Kelimeler

• Charcot artropati
• tibiokalkaneal artrodez
• uzuv kurtarma
• çivileme
• diabetes mellitus

Kaynakça

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