Charcot arthropathy is a bone and joint disease that is more common in diabetic patients due to peripheral neuropathy and restricted blood flow. It can lead to deformities and amputation in severe cases, and treatment options include surgery and follow-up care.
Charcot arthropathy is a disease of the bones and joints in which the patient becomes more prone to fractures and dislocations and may not notice them initially due to damage to surrounding nerves, which limits pain signals. Doctors began identifying this condition in the 1700s. Today, it is more common in patients with diabetes, particularly in patients who have difficulty controlling their diabetes. An orthopedic surgeon usually has to provide treatment, and options may include setting and fusion of bones, reconstructive surgery, or amputation in extreme cases.
Several mechanisms play a role in the development of Charcot arthropathy. Patients with diabetes can develop peripheral neuropathy, in which nerves suffer damage over time, leading to loss of sensation, particularly in the extremities. When people get hurt, they may not realize it at first because they can’t feel it. This can lead to the development of infection and serious injury, as the patient does not seek treatment until the condition becomes very noticeable.
Diabetes also tends to cause vascular problems by restricting blood flow. Areas of the body that don’t get enough blood are more likely to be prone to injury and heal more slowly. Cells don’t get enough oxygen and nutrients due to impeded blood flow. In the case of Charcot’s arthropathy, a condition usually seen in the feet and ankles, the patient develops lesions in the bones and joints and does not notice them because they are not painful. When the lesions do not heal, the patient may eventually develop deformities and have difficulty walking.
A doctor can identify signs of Charcot arthropathy during a physical exam. The patient’s joints may appear swollen and distended, and in some cases, there are sores. If your doctor requests an X-ray, he or she will be able to see if there are any displaced and broken bones at the site. Treatment depends on the severity of the deformity and the patient’s general condition. Sometimes, surgery can be done and the joint reconstructed. The patient will need thorough follow-ups to verify healing and identify recurring damage as early as possible.
In other cases, the damage from Charcot’s arthropathy is severe or the patient is unable to properly heal the wound, and a doctor may consider amputation as an option. This is usually a last resort rather than a recommendation early in the treatment process. Amputation carries risks, and the patient will need to learn how to care for the site, as well as receive training in how to use a prosthesis for mobility.
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