Mid- to long-term outcomes of contemporary total knee arthroplasty in Charcot neuroarthropathy: a systematic review and meta-analysis

Piti Rattanaprichavej; Patapong Towiwat; Artit Laoruengthana; Piyameth Dilokthornsakul; Nathorn Chaiyakunapruk

doi:10.1302/2058-5241.6.200103

Mid- to long-term outcomes of contemporary total knee arthroplasty in Charcot neuroarthropathy: a systematic review and meta-analysis

EFORT Open Rev. 2021 Jul 8;6(7):556-564. doi: 10.1302/2058-5241.6.200103. eCollection 2021 Jul.

Authors

Piti Rattanaprichavej¹, Patapong Towiwat², Artit Laoruengthana¹, Piyameth Dilokthornsakul^{3

4}, Nathorn Chaiyakunapruk^{5

6}

Affiliations

¹ Department of Orthopaedics, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand.
² Department of Internal Medicine, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand.
³ Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
⁴ Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
⁵ Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah, USA.
⁶ School of Pharmacy, University of Wisconsin, Madison, Wisconsin, USA.

Abstract

Total knee arthroplasty (TKA) is an effective procedure to treat many patients with end-stage knee arthropathy. However, the extension of TKA for patients with Charcot neuroarthropathy (CNA) is controversial, with relatively limited evidence defining optimal reconstruction techniques.This systematic review of relevant studies that were published from January 2000 to June 2020 aimed to define survivorship, complications, reoperation, and component revision rates of contemporary TKA performed for CNA.We identified 127 TKA performed for CNA in five studies that comprised ≥ 7 knees with ≥ 5 years of follow-up.Overall implant survivorship was 85.4%. The overall complication rate was 26.4%, with the most common complications including instability (24.0%), periprosthetic fracture (17.4%), infection (13.0%), ligament injury (10.9%) and aseptic loosening (10.9%).The aetiology of CNA and prosthesis type had no influence on clinical outcomes, whereas the effect of staging of disease and ataxia status was still inconclusive.Understanding the potential determinants, survivorship and risk of complications related to TKA performed in CNA may help surgeons to deal with patient expectations. Cite this article: EFORT Open Rev 2021;6:556-564. DOI: 10.1302/2058-5241.6.200103.

Keywords: Charcot; neuro-syphilis; neuroarthropathy; total knee arthroplasty.

Publication types

Review