Transarticular versus Transosseous Amputations in Diabetic Foot Osteomyelitis: A Retrospective Comparative Study

Area of Science:

• Orthopedic Surgery
• Diabetic Foot Management
• Infectious Disease

Background:

• Diabetic foot osteomyelitis (DFO) frequently requires minor amputations.
• Reamputations are common after initial DFO procedures.
• The impact of amputation type on DFO outcomes is not well-established.

Purpose of the Study:

• To compare clinical and microbiological failure rates between transarticular and transosseous amputations in DFO patients.
• To evaluate the long-term effects of different minor amputation types on DFO treatment success.

Main Methods:

• A prospective study followed 284 DFO patients undergoing 543 minor foot amputations (203 transarticular, 340 transosseous) for one year.
• Clinical and microbiological failure rates were assessed using comparative statistics, survival analyses, and Cox regressions.

Main Results:

• No significant difference in clinical failure (21.7% transarticular vs. 22.9% transosseous) or reamputation rates was observed.
• Microbiological failure rates were also similar between the two amputation types (5.4% vs. 6.2%).
• Amputation type did not significantly influence clinical or microbiological failure in multivariate analysis.

Conclusions:

• Transarticular and transosseous amputations demonstrate comparable clinical and microbiological outcomes within one year for DFO.
• The choice between transarticular and transosseous amputation does not appear to affect reamputation risk in DFO patients.