Abstract
Category:
Diabetes
Introduction/Purpose:
Patients with Charcot Foot Arthropathy objectively report a poor quality of life following the development of deformity. It has recently been demonstrated that their quality of life is not improved with historic accommodative treatment. The recent interest in surgical reconstruction of the acquired deformity is directed at improving quality of life in addition to traditional goals of resolution of infection and limb retention. The Short Musculoskeletal Functional Assessment (SMFA) has been proven to be a valid tool for evaluating this complex patient population.
Methods:
Twenty-five consecutive patients undergoing surgical reconstruction for non-plantigrade midtarsal charcot foot arthropathy completed the SMFA patient reported outcomes instrument prior to surgery, with twenty-four completing it at one year following the surgery. One patient died during the year following surgery due to unrelated causes.
Results:
There was an 11.47 (95% CI: -19.70 to -3.23) point decrease in the standardized functional index. (p = .01) Similarly, there was a 12.38 (95% CI: -22.48 to -2.29) point de-crease in the standardized bother index. (p = .02) There was a 19.58 (95% CI: -30.53 to -8.63) point decrease in the standardized daily activity index. (p = .002), and there was an 14.68 (95% CI: -24.06 to - 5.31) point decrease in the standardized emotion index (p = .004). There was no meaningful change in the standardized arm/hand index. (p = .81)
Conclusion:
The results of this investigation demonstrate that successful surgical reconstruction of midtarsal Charcot Foot Arthropathy substantially improves quality of life. This supports the modern paradigm shift from immobilization during the active phase of the disease process followed by simple accommodation of the acquired deformity, to the modern approach of surgical correction to allow the use of commercially-available therapeutic footwear.