Deciphering Bone Microarchitecture in Diabetic Charcot Neuroarthropathy of Foot: A Case Control Study

Area of Science:

• Orthopedics
• Diabetology
• Bone Histopathology

Background:

• Charcot neuroarthropathy (CNO) of the foot is associated with increased bone turnover and resorption.
• Histological evidence of bone changes in CNO foot is not well understood.

Purpose of the Study:

• To investigate the histological characteristics of foot bones in patients with Charcot neuroarthropathy (CNO).
• To compare bone microarchitecture and cellular activity in CNO foot with diabetic foot ulcers and healthy controls.

Main Methods:

• Calcaneum bone samples were obtained from patients with CNO foot (n=10), diabetic foot ulcers (n=16), and healthy controls (n=16).
• Histological sections were stained and evaluated for quantitative parameters including bone trabeculae number and thinning, osteoclast number, and Howship's lacunae.

Main Results:

• CNO foot samples showed significantly reduced normal bone trabeculae (15%) and increased thin trabeculae (10%) compared to controls.
• Increased osteoclast numbers and Howship's lacunae were observed in both CNO foot and diabetic foot ulcer groups compared to controls (P < 0.001).

Conclusions:

• Increased bone resorption, characterized by thinned trabeculae, elevated osteoclasts, and Howship's lacunae, is evident in CNO of the foot.
• Targeting osteoclast activity with anti-resorptive therapies may be a promising treatment strategy for diabetic CNO foot.