Showing posts with label Charcot arthropathy. Show all posts
Showing posts with label Charcot arthropathy. Show all posts

Monday, October 1, 2007

Conservative treatment of Charcot artroparthy in a series of spina bifida patients: the experience of one center and review of the literature.

Yalcin S, Kocaoglu B, Berker N, Erol B. Conservative treatment of Charcot artroparthy in a series of spina bifida patients: the experience of one center and review of the literature. Journal of Pediatric Orthopedic B. 2007 Sep;16(5):373-9.

The present study was performed to evaluate the use of patellar tendon-bearing ankle foot orthesis for the treatment of Charcot arthropathy in a series of patients with spina bifida. A cohort of 350 spina bifida patients, ages ranging between 12 months and 22 years were evaluated in our clinic between June 1993 and March 2004. Charcot arthropathy was seen in five of these children. Treatment was initiated with nonsteroidal anti-inflammatory drugs, oral bisphosphonates and immobilization. No change was observed in the patients' symptoms after a month of treatment. At this time, a patellar tendon-bearing ankle foot orthesis was prescribed and used for a period of 6 to 24 months. All patients improved within 2 months. At the end of 2 years of follow-up, three patients are still using the brace without any complaints. One patient still has symptoms, although she is wearing her brace, but she has had significant improvement compared with the initiation of therapy. Non-weight-bearing, immobilization and surgery are the known treatment choices in Charcot arthropathy. Little experience exists about this entity and its treatment. Our experience reveals that the patellar tendon-bearing ankle foot orthesis leads to significant improvement in children with Charcot arthropathy without surgery and immobilization.

PMID: 17762679

Charcot arthropathy in spina bifida.

Nagarkatti DG, Banta JV, Thomson JD. Charcot arthropathy in spina bifida. Journal of Pediatric Orthopedics. 2000 Jan-Feb;20(1):82-7.

This multicenter study was undertaken to identify the prevalence of Charcot arthropathy in the spina bifida population; to evaluate the relationship of neurosegmental level, ambulatory level, and distribution of joint involvement; and to assess treatment results and make treatment recommendations. Sixteen patients were identified with Charcot arthropathy based on clinical and radiographic criteria ranging in age from 9 to 42 years. There were 15 ankles, seven knees, and four hips identified with Charcot arthropathy. Six patients underwent surgery and modification of orthoses, eight had a modification of orthoses only, one had no modification, and one was lost to follow-up. Mean follow-up was 4 years and 9 months (with four good, 17 fair, and five poor results). The best results were seen in 13 compliant patients with a brace modification, whereas poor results were seen in three patients with poor brace compliance. Based on our study, we have noted the prevalence of Charcot arthropathy in spina bifida to be one in 100 cases.

PMID: 10641695