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Partial Calcanectomy in Patients with Charcot's Neuroarthropathy
Craig J Verdin1, Nicole K Cates2, Holly D Shan1
1*Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC.
Journal of the American Podiatric Medical Association
|December 30, 2025
Summary
Partial calcanectomy in patients with Charcot's neuroarthropathy (CN) rarely causes significant limb threat. However, it can destabilize the rearfoot, leading to new CN breakdown in some cases.
Area of Science:
- Orthopedics
- Podiatry
- Diabetic Foot Care
Background:
- Limb salvage procedures can cause biomechanical dysfunction.
- Charcot's neuroarthropathy (CN) patients are at risk for further breakdown after interventions.
- Rearfoot interventions like partial calcanectomy have not been studied for CN progression.
Purpose of the Study:
- To investigate the risk of new or progressive Charcot's neuroarthropathy (CN) after partial calcanectomy in patients with existing CN.
- To evaluate the radiographic and clinical outcomes of partial calcanectomy in this patient population.
Main Methods:
- Retrospective review of eight patients with a history of CN who underwent partial calcanectomy.
- Analysis of medical records and radiographic characterization over a 7.25-year period.
- Exclusion of patients with contralateral limb involvement.
Main Results:
- Two patients (25%) showed multi-joint breakdown; three developed CN post-calcanectomy.
- Sanders-Frykberg classifications ranged from SF II to SF IV/V.
- Post-calcanectomy CN occurred a mean of 350 days after surgery, affecting the rearfoot joints, with a 66.7% limb salvage rate.
Conclusions:
- Partial calcanectomy does not significantly threaten limbs in antecedent CN patients.
- Clinicians should be aware of the potential for rearfoot CN breakdown post-calcanectomy.
- Three cases of post-calcanectomy CN breakdown highlight the need for vigilance regarding this complication.
