Lower-extremity amputation risk after charcot arthropathy and diabetic foot ulcer.
OBJECTIVE
To compare risks of lower-extremity amputation between patients with Charcot arthropathy and those with diabetic foot ulcers.


METHODS
A retrospective cohort of patients with incident Charcot arthropathy or diabetic foot ulcers in 2003 was followed for 5 years for any major and minor amputations in the lower extremities.


RESULTS
After a mean follow-up of 37 +/- 20 and 43 +/- 18 months, the Charcot and ulcer groups had 4.1 and 4.7 amputations per 100 person-years, respectively. Among patients <65 years old at the end of follow-up, amputation risk relative to patients with Charcot alone was 7 times higher for patients with ulcer alone and 12 times higher for patients with Charcot and ulcer.


CONCLUSIONS
Charcot arthropathy by itself does not pose a serious amputation risk, but ulcer complication multiplicatively increases the risk. Early surgical intervention for Charcot patients in the absence of deformity or ulceration may not be advisable.
Sohn
Min-Woong
MW
Center forManagement of Complex Chronic Care, Hines Veterans Affairs Hospital, Hines, Illinois, USA. min-woong.sohn@va.gov
Stuck
Rodney M
RM
Pinzur
Michael
M
Lee
Todd A
TA
Budiman-Mak
Elly
E
D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D001177:Arthropathy, Neurogenic / Q000150:complications* / Q000453:epidemiology* / Q000601:surgery; D017719:Diabetic Foot / Q000150:complications* / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005528:Foot / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged