Working Toward A Better Definition And Treatments For The Charcot Foot

David G. Armstrong DPM MD PhD

The American Diabetes Association and the American Podiatric Medical Association recently convened an international task force of experts to make recommendations on the diabetic Charcot foot. The meeting was located in Paris at the famous Pitié-Salpêtrière Hospital, the institution where Jean-Martin Charcot practiced in the 19th century.

The committee reached a consensus on the definition, pathophysiology, diagnosis and recommended treatment of the Charcot foot. Based on the task force proceedings, I think that what we’re going to be seeing is that the bone breakdown associated with Charcot is just the last stages of what is very likely a long-term inflammatory problem. Defining the beginning and the end of that problem is what this meeting was all about. I think that is going to be very exciting.

As with many of our colleagues, we see many people with Charcot at the Southern Arizona Limb Salvage Alliance (SALSA). We probably have several of these patients per week, many of whom are referred from around the region and around the country. We have begun treating people aggressively in an anti-inflammatory fashion, much more so after the last several months. This has had something to do with our participation in this task force.

There is a huge section on Charcot at the upcoming Diabetic Foot Global Conference (DFCon) and a lot of it is about the latest and greatest from this task force as well as the practical aspects of the medical and aggressive complex surgical treatment of this problem. There will be a lot in terms of hands-on workshops at DFCon, which will be held from March 24 to 26 in Los Angeles ( ).

In addition to myself, the task force members were co-chair Lee C. Rogers, DPM, co-chair Robert G. Frykberg, DPM, Andrew J.M. Boulton, MD, Michael Edmonds, MD, Agnes Hartemann-Heurtier, MD, Georges Ha Van, MD, Fran Game, MD, FRCP, William Jeffcoate, MD, MRCP, Alexandra Jirkovska, MD, PhD, Edward Jude, MD, MRCP, Stephan Morbach, MD, William Morrison, MD, Michael Pinzur, MD, Dario Pitocco, MD, Lee Sanders, DPM, Dane Wukich, MD, and Luigi Uccioli, MD. I give a lot of credit to Dr. Rogers, Dr. Frykberg and Dr. Sanders for the work they have done on the Charcot task force.

The task force report will be jointly published in Diabetes Care and the Journal of the American Podiatric Medical Association later this year and presented at both associations' scientific meetings. The ADA/APMA task force meeting was supported by unrestricted educational grants from Small Bone Innovations, Integra Life Sciences and Sanofi-Aventis.

This blog has been adapted with permission from a previous blog that originally appeared at .

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