Can Bisphosphonates Lead To Better Charcot Treatment?

By William Scott Rogers

When managing patients in the acute phase of Charcot neuroarthropathy, the hallmark of treatment is immobilization and non-weightbearing of the affected foot until the destructive nature of this stage disappears and the coalescence stage begins. In the past decade, researchers have hypothesized that using bisphosphonates in acute Charcot patients can decrease pathological fractures and permanent deformity, which commonly occur in these patients.If this is true, then using bisphosphonates may also lead to less deformity, shorter treatment time, a decreased need for revisional surgery, decreased ulceration and far less expense than treatment currently entails.
Bisphosphonates are used to treat various diseases of bone and calcium metabolism characterized by increased bone resorption, including osteoporosis, Paget’s disease, primary hyperparathyroidism, hypercalcemia of malignancy and metastatic bone disease. They effectively act by inhibiting osteoclast activity. Bisphosphonates are specifically targeted to the skeleton but may even localize preferentially at sites of active bone resorption.

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