Lower-Extremity Amputation Risk Following Charcot Arthropathy and Diabetic Foot Ulcer

Objective:

To compare risks of lower-extremity amputation between patients with Charcot arthropathy and those with diabetic foot ulcers.

Research Design and Methods:

A retrospective cohort of patients with incident Charcot arthropathy or diabetic foot ulcers in 2003 was followed for five years for any major and minor amputations in the lower extremities.

Results:

After a mean follow-up of 37±20 and 43±18 months, the Charcot and ulcer groups had 4.1 and 4.7 amputations per 100 person-years, respectively. Among patients < 65 years old at the end of follow-up, amputation risk relative to patients with Charcot alone was seven times higher for patients with ulcer alone and twelve times higher for patients with Charcot and ulcer.

Conclusions:

Charcot arthropathy by itself does not pose a serious amputation risk, but ulcer complication multiplicatively increased the risk. Early surgical intervention for Charcot patients in the absence of deformity or ulceration may not be advisable.

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