Evidence map›Paper›PMID 32700577›Full record

ArticleFoot & ankle international2020

Midterm Fate of the Contralateral Foot in Charcot Arthropathy.

Felix W A Waibel, Martin C Berli, Viviane Gratwohl, Kati Sairanen, Dominik Kaiser, Laura Shin, David G Armstrong, Madlaina Schöni

Open access · greenAbstract read
In one paragraph

Article in Foot & ankle international, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.4field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 13 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 2 countries.

Felix W A WaibelDepartment of Orthopedic Surgery, Balgrist University Hospital, Zurich, Switzerland.ORCID https://orcid.org/0000-0003-3991-8743
Martin C BerliDepartment of Orthopedic Surgery, Balgrist University Hospital, Zurich, Switzerland.
Viviane GratwohlDepartment of Orthopedic Surgery, Balgrist University Hospital, Zurich, Switzerland.
Kati SairanenUnit for Clinical and Applied Research, Balgrist University Hospital, Zurich, Switzerland.
Dominik KaiserDepartment of Orthopedic Surgery, Balgrist University Hospital, Zurich, Switzerland.
Laura ShinDepartment of Surgery, The Southwestern Academic Limb Salvage Alliance (SALSA), Keck School of Medicine of University of Southern California (USC), Los Angeles, CA, USA.
David G ArmstrongDepartment of Surgery, The Southwestern Academic Limb Salvage Alliance (SALSA), Keck School of Medicine of University of Southern California (USC), Los Angeles, CA, USA.
Madlaina SchöniDepartment of Orthopedic Surgery, Balgrist University Hospital, Zurich, Switzerland.ORCID https://orcid.org/0000-0002-3688-2223
Universitätsklinik Balgrist · CHUniversity of Southern California · US

Funding

Southern California Clinical and Translational Science InstituteUL1TR001855 · NCATS · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Thomas A Buchanan, Michele D. Kipke · 2016 to 2026
$81.3M
Improving the science of adherence reinforcement and safe mobility in people with diabetic foot ulcers using smart offloadingR01DK124789 · NIDDK · UNIVERSITY OF SOUTHERN CALIFORNIA · PI ARMSTRONG, DAVID GEORGE, NAJAFI, BIJAN · 2021 to 2025
$2.0M
NCATS NIH HHS UL1 TR001855NIDDK NIH HHS R01 DK124789
6 · The paper itself

Abstract

backgroundThe contralateral foot in Charcot arthropathy or neuroarthropathy (CN) is subject to increased plantar pressure. To date, the clinical consequences of this pressure elevation are yet to be determined. The aim of this study was to evaluate ulcer and amputation rates of the contralateral foot in CN.

methodsWe abstracted the medical records of 130 consecutive subjects with unilateral CN. Rates of contralateral CN development and recurrence, contralateral ulcer development, and contralateral amputations were recorded. Statistical analysis was performed to identify possible risk factors for contralateral CN and ulcer development, and contralateral amputation. Mean follow-up was 6.2 (SD 4) years.

resultsAfter a mean of 2.5 years, 19.2% patients developed contralateral CN. Female gender was associated with contralateral CN development (odds ratio 3.13, 95% confidence interval 1.27, 7.7). Overall, 46.2% patients developed a contralateral ulcer. Among the patients who developed contralateral CN, 60% developed an ulcer. Sanders type 2 at the index foot (midfoot CN) was significantly associated with contralateral ulcer development. Ulcer-free survival (UFS) differed significantly between patients with diabetes type 1 (median UFS 5131 days) and patients with diabetes type 2 (median UFS 2158 days). A total of 25 amputations had to be performed in 22 (16.9%) patients. Three of those 22 patients (2.3%) needed major amputation.

conclusionAlmost 20% of patients developed contralateral CN. Nearly half of people with CN developed a contralateral foot ulceration. Patients with type 2 diabetes had significantly shorter UFS than patients with diabetes type 1. Every sixth patient needed an amputation, with the majority being minor amputations. The contralateral foot should be monitored closely and included in the treatment in patients with CN. LEVEL OF EVIDENCE: Level IV, retrospective study.

Indexed as

AdultAmputation, SurgicalArthropathy, NeurogenicDiabetes Mellitus, Type 2FootFoot UlcerHumansRecurrenceRetrospective StudiesCharcot footdiabeteslimb lossmajor amputationulcer

Identifiers

PMID32700577
PMCPMC8351021
OpenAlexW3045406947

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.