Treatment of Ankle Charcot Arthropathy
10.14193/jkfas.2026.30.1.1
- Author:
Youngkwan MOON
1
;
Youngrak CHOI
Author Information
1. Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Publication Type:Review Article
- From:Journal of Korean Foot and Ankle Society
2026;30(1):1-5
- CountryRepublic of Korea
- Language:English
-
Abstract:
Charcot arthropathy of the ankle is an uncommon but limb-threatening neurogenic arthropathy that may rapidly progress to instability, deformity, ulceration, and deep infection. A diagnosis is often delayed because pain can be mild, and inflammatory signs can mimic infection. This review summarizes the current concepts in the management of ankle Charcot arthropathy, emphasizing early assessment and individualized treatment. The initial evaluation is based on a clinical assessment and weightbearing radiographs. Computed tomography (CT), magnetic resonance imaging, and radiolabeled white blood cell SPECT/CT may be used selectively to define the anatomy, assess the disease activity, or evaluate suspected infections. In the active phase, prompt immobilization and strict off-loading, typically with total contact casting, are fundamental, and a transition to therapeutic footwear and custom orthoses should be gradual. Surgery may be indicated for progressive deformities or instability that threatens the skin integrity despite the appropriate conservative management, but the optimal timing remains controversial. Procedure selection should be individualized based on the disease extent, bone loss, soft-tissue status, and infection. Robust internal, external, or hybrid fixation can be used, and staged approaches are preferred when ulceration or osteomyelitis is present.
