Abstract
Background. Charcot neuroarthropathy (CN) is a rare joint destructive process that occurs in the setting of peripheral neuropathy. CN can cause deformity and joint instability and has been shown to decrease quality of life. Given the rarity but severity of this condition, a better understanding of the epidemiology and treatment trends are needed. Therefore, the purpose of this study was to explore recent trends in the observed cumulative burden of CN as well as the incidence of different surgical treatments. Methods. This study utilized a large commercial insurance claims database to estimate the diagnostic cumulative burden of CN from 2009 to 2019. Patients were identified through International Classification of Disease codes. Current procedural terminology (CPT) codes were cross-matched with diagnostic codes to identify patients who underwent surgical procedures related to their CN. Incidence rates of procedures were calculated to assess for trends in management, stratified by age, sex, and geographic region. Results. From 2009 to 2019, the cumulative case rate of CN increased from 2.96 to 5.00 patients per 10 000 people (estimated 12 836 observed cases starting in 2009 to 167 145 observed cumulative cases by 2019) in the United States. In this time period, the total incidence of surgical procedures performed for these patients increased from 4.35 to 9.70 procedures per 100 000 person-years. The most common procedures included debridement and excision/resection procedures (75.21%) and arthrodesis or osteotomy procedures (9.85%). Conclusion. Current epidemiological trends for CN are not well known. This study demonstrated an increasing case burden of CN within the United States, alongside increasing incidences of surgical procedures for this disease. These trends provide important insights for patient-specific and public health advocacy. Future studies should continue to explore the contributory financial, cultural, and educatory factors of this disease.
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