Peripheral Vascular Disease Diagnostic Related Outcomes in Diabetic Charcot Reconstruction

Publication date: November 2019Source: The Journal of Foot and Ankle Surgery, Volume 58, Issue 6Author(s): Nicole K. Cates, Tammer Elmarsafi, Taylor J. Bunka, Elliot T. Walters, Cameron M. Akbari, Caitlin Zarick, Karen K. Evans, John S. Steinberg, Christopher E. Attinger, Paul J. KimAbstractPostreconstructive outcomes were compared in diabetic patients with Charcot neuroarthropathy (CN) who had peripheral arterial disease (PAD) diagnosed with angiography versus patients who were diagnosed clinically. A retrospective review was performed of patients with diabetic CN requiring reconstruction secondary to ulceration and/or acute infection. Of the 284 patients in the CN osseous reconstruction cohort, after accounting for exclusion criteria, 59 (20.8%) patients with PAD were included in the analyses. Forty (67.8%) of these 59 patients were diagnosed with PAD clinically and 19 (32.2%) were diagnosed with the use of angiography. Bivariate analysis was used to compare outcomes between those diagnosed with PAD via angiography versus those diagnosed clinically for the following postreconstruction outcomes: wound healing, delayed healing, surgical site infection, pin tract infection, osteomyelitis, dehiscence, transfer ulcer, new site of Charcot collapse, contralateral Charcot event, nonunion, major lower extremity amputation, and return to ambulation. Bivariate analysis found return to ambulation postreconstruction (p = .0054) to be the only statistically significant factor. There ...
Source: The Journal of Foot and Ankle Surgery - Category: Orthopaedics Source Type: research