Long-term outcome and quality of life in patients with Charcot foot |
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| Authors: | Toni-Karri Pakarinen Heikki-Jussi Laine Heikki Mäenpää Pentti Mattila Jorma Lahtela |
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| Affiliation: | 1. Resident, Podiatric Medicine and Surgery Residency Program, University of Pittsburgh Medical Center, Pittsburgh, PA;2. Fellow, Orthopedic Foot and Ankle Center, Westerville, OH;3. Biostatistician, Clinical Outcomes Research, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA;4. Assistant Professor, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA;5. Director, Podiatric Medicine and Surgery Residency Program, University of Pittsburgh Medical Center, Pittsburgh, PA;6. Chief, Podiatry Section, University of Pittsburgh Medical Center Mercy Hospital, Pittsburgh, PA;1. Applied Kinesiology Laboratory, Program in Physical Therapy, Campus Box 8502, Washington University School of Medicine, St. Louis, MO, 63108;2. Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AK;3. Electronic Radiology Laboratory, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO;4. Musculoskeletal Biomechanics Laboratory, Program in Physical Therapy, Doisy College of Health Sciences, Saint Louis University, St. Louis, MO;5. Foot & Ankle Service, Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO |
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| Abstract: | BackgroundThere is only sparse scientific data about the long-term effects of the Charcot foot on patients’ lives and the clinical outcome. This study evaluates the long-term effects of diabetic Charcot foot.MethodsA cross-sectional follow-up study of consecutive series of patients with Charcot foot referred to the University Hospital Diabetic Foot and Ankle Clinic between 1991 and 2002.ResultsForty-one patients were referred with Charcot foot between 1991 and 2002. After an average follow-up of 8 years their overall mortality rate was 29% (12/41) and 29 patients (30 Charcot feet) have been followed more than 5 years. Sixty-seven percent of Charcot feet suffered at least one episode of ulceration and 50% (15/30) of affected feet had surgical treatment resulting in 29 operations. Simple exostectomy was successful in 62% of cases. The need for surgical management increased markedly 4 years after the diagnosis. Correct diagnosis within 3 months resulted in better functional outcome (AOFAS) and walking distance (p = 0.006 and p = 0.008, respectively). Lower SF-36 component scores in physical functioning, social functioning and general health perceptions were found when the study population was compared to the general population and chronically ill control subjects.ConclusionsDiabetic Charcot foot decreases patient's physical functioning and general health but does not usually affect mental health. Surgical management is often required with an increase 4 years post-diagnosis. A delay of diagnosis of more than 3 months was found to adversely affect the quality of life and functional outcome. |
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