|Charcot's Arthropathy -
Management of acute Charcot's
Prevention of further destruction and deformity of the foot
at the acute phase is the primary goal of treatment. It is
therefore essential to prevent the patient walking on the
fragile bones until they have a chance to heal. The mainstay of
current treatment is placing the foot in a well moulded contact
cast to relieve pressure and to preserve foot shape. Patients
remain in the contact cast until there is no major difference in
the temperature and swelling between the affected and unaffected
feet. This usually takes between 6-9 months.
Application of a contact cast
If treated early, the foot is not grossly deformed. Patients
can avoid the need for specialist footwear and have a good
chance of avoiding ulceration.
If not treated early, the foot affected by Charcot's
arthropathy becomes very deformed and ulcer prone. Treatment at
this stage is palliative and relies on special foot wear,
regular podiatry treatment and limitation of activities.
Amputation is sometimes required because of intractable
ulceration. Therefore diagnosing Charcot's arthropathy at the
acute stage of a "swollen foot" is essential and limb saving.
A grossly deformed Charcot's
joint with neuropathic ulcer.
There is no proven specific pharmacological treatment for
Charcot's arthropathy. There has been a report that a group of
drugs known as the biphosphonates may be useful. These are
currently undergoing clinical trials.