Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.
J Foot Ankle Res. 2024 Dec;17(4):e70016. doi: 10.1002/jfa2.70016.
Charcot neuroarthropathy (CN) can result in fractures and dislocations of the foot and ankle in individuals with diabetes and neuropathy, leading to ulceration, amputation and a poor quality of life. Additional episodes of acute CN can lead to extended periods of physical and psychosocial distress. The aim of this scoping review was to identify and synthesise the evidence relating to factors associated with the development of recurrent and contralateral Charcot neuroarthropathy (CN) in individuals with diabetes.
A systematic search of four electronic databases was conducted from inception to February 06, 2023. All relevant study designs, except single case studies, that had been published in full in peer-reviewed journals were included. Studies were excluded if they were not published in English and did not provide data on individuals with diabetes.
The search identified two studies that investigated factors associated with the development of recurrent CN, but none that related to the development of contralateral CN. Ten factors were investigated for association with recurrent CN development: age, body mass index, diabetes type and duration, glycated haemoglobin, anatomical site affected, duration of offloading applied to treat the primary CN episode, use of pharmacological intervention, severity of neuropathy, and skin temperature. However, no significant associations were reported.
There is an alarming lack of evidence-based findings in this research area to guide practice. Clearly, more research in the form of rigorous prospective studies is urgently required to identify risk factors for the development of recurrent and contralateral CN in individuals with diabetes.
夏科氏关节病（CN）可导致糖尿病和神经病变患者足部和踝关节骨折和脱位，导致溃疡、截肢和生活质量下降。CN 的急性发作次数增加会导致身体和社会心理困扰的延长。本综述的目的是确定和综合与糖尿病患者复发性和对侧夏科氏神经关节病（CN）发展相关的因素的证据。
从成立到 2023 年 2 月 6 日，对四个电子数据库进行了系统搜索。所有相关的研究设计，除了单一病例研究，只要已在同行评审期刊上全文发表，都包括在内。如果研究不是用英文发表的，并且没有提供有关糖尿病患者的数据，则将其排除在外。
搜索确定了两项研究调查了与复发性 CN 发展相关的因素，但没有一项与对侧 CN 发展相关。有 10 个因素被调查与复发性 CN 发展相关：年龄、体重指数、糖尿病类型和持续时间、糖化血红蛋白、受影响的解剖部位、用于治疗原发性 CN 发作的减压时间、药物干预的使用、神经病变的严重程度和皮肤温度。然而，没有报告显著的相关性。
在这个研究领域，令人震惊的是缺乏循证发现来指导实践。显然，迫切需要更严格的前瞻性研究来确定糖尿病患者复发性和对侧 CN 发展的风险因素。
