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Treatment of Charcoat Joints using Total Knee Arthroplasty


Presenting Author - Abhijit Sahu
Total knee arthroplasty in neuropathic Charcot joints is technically demanding. Caused by a combination of sensory, motor and autonomic neuropathy, it was originally described as an arthritic sequelae of neurosyphilis. The knee is one of the most frequently affected large joints by the neuropathic process. The degenerative process, with gross deformity and destruction in some cases, may lead to significant disability for the patient. Traditional management has usually been conservative or arthrodesis, with limited success. Arthroplasty of a Charcot joint has commonly been avoided at all costs. However, in the right patient, using the right technique & instrumentation, arthroplasty can significantly improve the symptoms of a Charcot joint. This paper explores the evidence surrounding the role of arthroplasty in the management of a Charcot knee. We also would like to share our experience of treating Charcoat joint using total knee replacement in two patients with a current follow up of two years and would be discussing the complications encountered , how we managed them and got a successful outcome. Surgical techniques are explored in an attempt to define the role of arthroplasty in the management of a Charcot knee. I would like to conclude by saying total knee arthroplasty may be offered to a select group of patients with end stage neuropathic arthropathy.