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Radiographic and Clinical Outcomes in Patients With Charcot Neuroarthropathy Undergoing 1-Stage Screw Arthrodesis:
Tamara Hernádez Bermúdez1, Itzel Caldiño Lozada1, Ramón Ignacio Esperón Hernández1
1Foot and Ankle Surgery Service, Mexican Red Cross Orthopedic Hospital, Yucatán, Mexico.
Background:
To determine the functional and radiographic outcomes, as well as complications, in patients diagnosed with Charcot neuroarthropathy (Sanders/ Frykberg types II, III, and IV; Eichenholtz stages II and III) treated with 1-stage arthrodesis using screw-based superconstructs, with a 1-year follow-up.
Methods:
Patients treated with the Caldiño method for Charcot neuroarthropathy who underwent 1-stage arthrodesis (panastragalodesis and triple arthrodesis) using screw-based superconstructs between January 2023 and August 2024 were followed. The visual analog scale (VAS) for pain were assessed preoperatively and postoperatively, clinical results and complications were analyzed along with patient satisfaction and the degree of radiographic consolidation at 1-year follow-up.
Results:
Twenty-four patients were included, with equal sex distribution and a mean age of 54.5 years. The right foot was affected in slightly more than half of cases. Panastragalodesis was performed in the majority of patients, whereas the remaining patients underwent triple arthrodesis with preservation of the tibiotalar joint. A significant postoperative reduction in pain was observed, with mean VAS scores decreasing from 6.2 preoperatively to 0.7 at final follow-up. Radiographic evaluation demonstrated advanced consolidation in most patients. Minor postoperative complications were observed in fewer than half of the cohort and consisted primarily of superficial wound complications, all of which were managed conservatively and resolved within the early postoperative period.
Conclusion:
In this case series, screw arthrodesis, using superconstruction principles for the management of Charcot neuroarthropathy, was associated with satisfactory radiographic consolidation at 1-year follow-up, a substantial reduction in pain between pre- and postoperative periods, and the restoration of a stable, aligned, and pain-free plantigrade foot in patients with Eichenholtz stages II and III Charcot neuroarthropathy. Although complications did occur, minor wound-related complications were the most frequent and could be managed with conservative treatment, without the need for reintervention. Screw arthrodesis is a viable limb-sparing option in selected patients with advanced Charcot deformity.
Level Of Evidence:
Level IV, retrospective case series.
