The PA Foot and Ankle Associates blog gets questions from all over the world about foot and ankle health. Today we received this one from Manohar in Bangalore City, India.
“Hello sir. This is Manohar from India, Bangalore City. My father is suffering with charcot joint disease and also a diabetic neuropathy. In the last month his leg is completely swelling. An orthopedic surgeon has suggested amputation. My question is how can it be cured?”
Thanks for your question, Manohar. The doctors at PA Foot and Ankle Associates, and particularly Dr. Thomas Rocchio, are one of the United States’ foremost experts on Charcot foot disorder.
Charcot foot disorder is a side effect of diabetes and is accompanied by diabetic peripheral neuropathy. Diabetes damages blood vessels, causing a decrease in blood flow to the feet. Poor circulation weakens bones, resulting in a disintegration of bones and joints in the foot and ankle. This puts the bones at high risk of fracture. Unfortunately, a diabetic who has nerve damage from DPN has a loss of sensation in their feet, and will be unaware of the bones fracturing. They continue to walk on the foot, causing the joints to eventually collapse and the foot to change shape, most notably to a rocker-bottom appearance. Sharp edges of bone may put pressure on the skin, creating the risk of chronic skin sores. It’s this end result – a combination of bone disintegration and trauma – which is known as Charcot foot disorder. It’s one of the most serious complications of diabetes.
Charcot is a very dangerous disease, as it is in many cases accompanied by bone infection. In highly advanced cases, sometimes amputation is the only realistic treatment. However, it is far from the only treatment.
“There are reconstruction options for many Charcot patients, but there needs to be circulation in the foot for it to heal.”, according to Dr. Rocchio. “Infection can affect the result as well. The remaining reconstructed bone must be free from infection and there must be enough healthy soft tissue to close the incisions. Usually an aggressive external fixation is needed to stabilize the reconstruction. Unfortunately, no complete answer can be given without an exam of the patient.”
Dr. Adam Teichman adds, “There are treatments to stabilize, correct, and prevent Charcot and the breakdown of the foot. For instance, if ulcers can be healed, infection can be cured, which allows a number of options to save the foot. Amputation is not a therapy, it’s a last resort.”
Early diagnosis of Charcot is key to saving the foot, which is why every diabetic should have their feet checked regularly by a podiatrist. Manohar, we’d be happy to examine your father and give you a complete diagnosis and treatment plan if you and he can travel to the States.