Charcot Foot Reconstruction

What Does Charcot Foot Reconstruction Involve?

Charcot reconstruction is a highly involved procedure, typically with a long and expansive rehabilitation course. Performing a Charcot reconstruction surgery usually requires multiple procedures and is often staged. In some instances, it requires the application and use of external fixator frames. At other times, internal fixation alone is sufficient. Most Charcot reconstruction cases involve the fusing of multiple joints, and sometimes of the ankle, to provide optimal functional outcomes. 

Anatomy of the Foot Affected By Charcot Foot

​​The anatomy of patients with Charcot neuroarthropathy has a collapsing of their foot bones that gradually worsen with time. It leads to collapsing and breaking in different parts of the foot and ankle. 

What Are the Common Symptoms Leading to Charcot Foot Reconstruction?

Charcot neuroarthropathy, as it is medically referred to, is a gradual destructive process of patients who have peripheral neuropathy. Peripheral neuropathy is the term used to signify the lack of sensation in the extremities of patients. It is a common complication of diabetes but also of long-standing alcohol use, polio, Guillain-Barre syndrome, leprosy, and following certain cancer treatments. Having this condition leads to inappropriate overuse due to the lack of feedback that they are overdoing it. For example, if a healthy patient injures their foot from over-activity, they will feel the pain, and that patient will know to rest following the injury. However, in the instance of a Charcot patient, they will continue to walk on that injured extremity since they are not aware of their injury due to lack of sensation. The presentation of an acute Charcot attack/flare-up, is a red, hot, swollen foot that is notably warmer than the contralateral side. In long-standing Charcot foot, the foot collapses, and the bottom is completely flattened out. This is referred to as a rocker bottom foot. 

What Tests Are Performed To Diagnose the Need for Charcot Foot Reconstruction?

Typically, an extensive amount of imaging is required to assess and surgically plan for a Charcot reconstruction surgery. This includes X-rays in specialized views, an MRI, and CT imaging with a 3D reconstruction image, which would all aid in the diagnosis, staging and deformity correction planning for a patient with Charcot.

Consult With a Specialist for Expert Evaluation of Charcot Foot

Contact Modern Orthopaedics of New Jersey to receive world-class help for Charcot Foot from the highly experienced team of surgeons!

How Is Charcot Foot Reconstruction Performed?

Charcot reconstruction surgery is performed in order to address each individual deformity that the patient is experiencing. A cookie-cutter treatment does not work for this condition; it requires extensive examination and addresses very specific patient needs. This includes their lifestyles and if they would be able to tolerate and rehabilitate from the proposed surgery or surgeries.

Frequently Asked Questions

What Is the Recovery Process Like After Charcot Foot Reconstruction?

Depending on the extent of deformity and the procedures performed to correct it, bone in the newly aligned positioning takes about 10-14 weeks to heal. In some instances, it can be even longer than that; everyone heals at a different pace. Throughout the healing course, it is very important to receive adequate levels of vitamin D and to consume protein in order to aid in the healing process. Malnourishment and inadequate levels of vitamin D and protein can lead to delays in the surgical site healing, causing potential wound formation, delayed bone healing, and even potential non-healing of the bone. The aggressiveness of physical therapy and rehabilitation will play a big role in the long-term patient outcome. 

Why Would Surgical Intervention Be Needed for Charcot Foot?

Surgery is beneficial for individuals who have chronic wounds caused by substantial deformity from Charcot neuroarthropathy. The presence of wounds predisposes patients to form bone infections, which may have disastrous consequences, including the potential of losing one’s limb or even losing one’s life. In some instances, depending on the extent of the deformity caused by Charcot, your surgeon may strongly recommend Charcot surgery in order to prevent further breakdown of bones, leading to greater deformity and the formation of wounds. Surgery can only be considered for certain patients who are deemed safe enough to tolerate it. 

How Long Does It Take To Fully Recover From Charcot Foot Reconstruction?

Full recovery and return to independent activities of daily living can happen as early as 6 months but typically are over the 8 months and greater mark. Again, this is highly dependent on the extent of deformity and the procedures performed to address them. Discuss any and all concerns with your surgeon at Modern Orthopaedics.

What Are the Potential Complications of Untreated Charcot Foot?

Patients with untreated Charcot neuroarthropathy fall under the risk of developing further deformity, wound formation, potential risk of bone infection, and even the possibility of losing one’s leg or life. It is a very serious condition and must be addressed urgently with your foot & ankle specialist.