Audit of acute Charcot%26apos;s disease in the UK: the CDUK study

作者：Game F L^*; Catlow R; Jones G R; Edmonds M E; Jude E B; Rayman G; Jeffcoate W J

来源：Diabetologia, 2012, 55(1): 32-35.

DOI：10.1007/s00125-011-2354-7

• Bisphosphonates
• Charcot foot
• Diabetic foot
• Neuro-osteoarthropathy

We studied factors associated with the development and resolution of acute Charcot foot using a web-based observational study. %26lt;br%26gt;Clinicians managing cases of acute Charcot foot in the UK and Ireland between June 2005 and February 2007 were invited to register anonymised details on a secure website. %26lt;br%26gt;A total of 288 cases (age 57.0 +/- 11.3 years [mean +/- SD]; 71.2% male) were registered from 76 centres. Of these, 36% of patients recalled an episode of relevant trauma in the preceding 6 months, while 12% had had surgery to the affected foot. In 101 (35%) cases, ulceration was present at registration and 20% of these had osteomyelitis. Non-removable off-loading devices were used at presentation in 35.4% of cases, with removable off-loading used in 50%. Data on resolution were available for 219 patients. The median time to resolution was 9 months in patients whose initial management included the use of non-removable off-loading, compared with 12 months in the remainder (p = 0.001). Bisphosphonates were administered intravenously in 25.4% and orally in 19.4% of cases. The median time to resolution in patients who received bisphosphonates was 12 months and was longer than in those who did not (10 months, p = 0.005). %26lt;br%26gt;The median time to resolution was longer than in earlier series. Although limited by being observational and non-randomised, these data suggest that the use of non-removable off-loading at presentation may shorten the time to resolution. They provide no evidence to indicate that the use of bisphosphonates is beneficial.

• 出版日期2012-1