title: Audit of acute Charcot's disease in the UK: the CDUK study.
abstract: OBJECTIVE
  We studied factors associated with the development and resolution of acute Charcot foot using a web-based observational study.
  
  
  METHODS
  Clinicians managing cases of acute Charcot foot in the UK and Ireland between June 2005 and February 2007 were invited to register anonymised details on a secure website.
  
  
  RESULTS
  A total of 288 cases (age 57.0 ± 11.3 years [mean ± SD]; 71.2% male) were registered from 76 centres. Of these, 36% of patients recalled an episode of relevant trauma in the preceding 6 months, while 12% had had surgery to the affected foot. In 101 (35%) cases, ulceration was present at registration and 20% of these had osteomyelitis. Non-removable off-loading devices were used at presentation in 35.4% of cases, with removable off-loading used in 50%. Data on resolution were available for 219 patients. The median time to resolution was 9 months in patients whose initial management included the use of non-removable off-loading, compared with 12 months in the remainder (p = 0.001). Bisphosphonates were administered intravenously in 25.4% and orally in 19.4% of cases. The median time to resolution in patients who received bisphosphonates was 12 months and was longer than in those who did not (10 months, p = 0.005).
  
  
  CONCLUSIONS
  The median time to resolution was longer than in earlier series. Although limited by being observational and non-randomised, these data suggest that the use of non-removable off-loading at presentation may shorten the time to resolution. They provide no evidence to indicate that the use of bisphosphonates is beneficial.
authors: Foot Ulcer Trials Unit, Department of Diabetes and Endocrinology, Nottingham University Hospitals Trust, City Hospital Campus, Hucknall Road, Nottingham, NG5 1PB, UK. fgame@futu.co.uk
authors: F L
authors: FL
authors: Game
authors: R
authors: R
authors: Catlow
authors: G R
authors: GR
authors: Jones
authors: M E
authors: ME
authors: Edmonds
authors: E B
authors: EB
authors: Jude
authors: G
authors: G
authors: Rayman
authors: W J
authors: WJ
authors: Jeffcoate
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001177:Arthropathy, Neurogenic / Q000150:complications / Q000188:drug therapy / Q000209:etiology* / Q000628:therapy*; D015331:Cohort Studies; D017719:Diabetic Foot / Q000150:complications / Q000188:drug therapy / Q000209:etiology* / Q000628:therapy*; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020407:Internet; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009983:Orthopedic Equipment / Q000009:adverse effects; D010019:Osteomyelitis / Q000150:complications; D011183:Postoperative Complications / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D010818:Practice Patterns, Physicians'; D006113:United Kingdom / Q000453:epidemiology; D014947:Wounds and Injuries / Q000503:physiopathology; D055815:Young Adult
chemical_list: D004164:Diphosphonates