title: Midfoot Charcot Neuroarthropathy in Patients With Diabetes: The Impact of Foot Ulceration on Self-Reported Quality of Life.
abstract: BACKGROUND
  Charcot neuroarthropathy (CN) and diabetic foot ulceration (DFU) are serious complications of diabetes mellitus (DM) that can result in infection, hospitalization, amputation, and have been shown to negatively affect quality of life (QOL). To the best of our knowledge, there are no studies in the literature that have specifically compared QOL in patients with diabetic CN without DFU to a group of patients with diabetic CN and concurrent DFU. The aim of this study was to compare self-reported assessments of QOL in patients with CN to a group of patients with CN and concomitant midfoot ulceration.
  
  
  METHODS
  We compared a group of 35 diabetic patients with midfoot CN and no ulcer to a group of 22 diabetic patients with midfoot CN and concurrent DFU. Self-reported outcome was assessed using the Medical Outcome Study Short Form 36 (SF-36) health survey and Foot and Ankle Ability Measure (FAAM).
  
  
  RESULTS
  No significant differences were found when comparing the 2 groups utilizing the SF-36 and FAAM with the exception that CN patients without foot ulcers had lower mean scores on the Bodily Pain Subscale. Both groups demonstrated negative impact on physical QOL and lower extremity function to a greater degree than mental QOL.
  
  
  CONCLUSIONS
  The presence of ulceration does not appear to significantly impact QOL in patients with CN when compared to patients with CN without ulceration.
  
  
  METHODS
  Prognostic, Level III: Case control.
authors.affiliation: Department of Plastic Surgery, Georgetown University School of Medicine, MedStar Georgetown University Hospital, Washington, DC (KMR)Heritage Valley Beaver Hospital, Beaver, Pennsylvania (KBH)Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania (BLR)Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (DKW).
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Raspovic
authors.affiliation: Department of Plastic Surgery, Georgetown University School of Medicine, MedStar Georgetown University Hospital, Washington, DC (KMR)Heritage Valley Beaver Hospital, Beaver, Pennsylvania (KBH)Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania (BLR)Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (DKW).
authors.forename: Kimberlee B
authors.initials: KB
authors.lastname: Hobizal
authors.affiliation: Department of Plastic Surgery, Georgetown University School of Medicine, MedStar Georgetown University Hospital, Washington, DC (KMR)Heritage Valley Beaver Hospital, Beaver, Pennsylvania (KBH)Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania (BLR)Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (DKW).
authors.forename: Bedda L
authors.initials: BL
authors.lastname: Rosario
authors.affiliation: Department of Plastic Surgery, Georgetown University School of Medicine, MedStar Georgetown University Hospital, Washington, DC (KMR)Heritage Valley Beaver Hospital, Beaver, Pennsylvania (KBH)Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania (BLR)Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (DKW) wukidk@upmc.edu.
authors.forename: Dane K
authors.initials: DK
authors.lastname: Wukich
mesh_terms: D001177:Arthropathy, Neurogenic / Q000150:complications / Q000523:psychology*; D005260:Female; D016523:Foot Ulcer / Q000150:complications / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D057566:Self Report; D011795:Surveys and Questionnaires
keywords: Charcot neuroarthropathy; SF-36; diabetic foot ulcer; quality of life