Weight bearing versus non-weight bearing total contact cast in the management of active Charcot foot: A systematic review

Aim: Diabetic Charcot neuro-osteoarthropathy carries a significant worldwide disease burden including diabetic foot infection, ulceration and amputation. The current accepted standard of treatment during the active phase of Charcot neuro-osteoarthropathy is offloading with total contact casting; how...

Full description

Saved in:
Bibliographic Details
Main Authors: Rachna Prem, Vikramman Vignaraja, Thomas Lewis, Basil Budair
Format: Article
Language:English
Published: SAGE Publishing 2024-12-01
Series:SAGE Open Medicine
Online Access:https://doi.org/10.1177/20503121241306957
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850114807143858176
author Rachna Prem
Vikramman Vignaraja
Thomas Lewis
Basil Budair
author_facet Rachna Prem
Vikramman Vignaraja
Thomas Lewis
Basil Budair
author_sort Rachna Prem
collection DOAJ
description Aim: Diabetic Charcot neuro-osteoarthropathy carries a significant worldwide disease burden including diabetic foot infection, ulceration and amputation. The current accepted standard of treatment during the active phase of Charcot neuro-osteoarthropathy is offloading with total contact casting; however, controversy remains regarding weight-bearing status during this period. Methods: A systematic review was performed following PRISMA guidelines of Pubmed, EMBASE, MEDLINE and the Cochrane central register of controlled trials for clinical studies from inception until June 2024 investigating weight-bearing and non-weight-bearing total contact casting for active Charcot neuro-osteoarthropathy. Results: Four hundred ninety-three studies were identified in the search strategy of which 5 studies met the inclusion criteria comprising 158 patients. These studies found that allowing patients to weight-bear during total contact casting does not have a negative impact on the healing process. There were no comparative studies between weight-bearing and non-weight-bearing total contact casting. Conclusions: There is limited evidence to support current practice of non-weight bearing in a total contact casting for active Charcot neuro-osteoarthropathy. Allowing patients to weight bear carries advantages to patient independence and quality of life. Further investigation with randomised control trial should be considered to investigate if weight bearing is associated with negative outcomes.
format Article
id doaj-art-5e57fb1f97bd4d06b2e279cbe3565155
institution OA Journals
issn 2050-3121
language English
publishDate 2024-12-01
publisher SAGE Publishing
record_format Article
series SAGE Open Medicine
spelling doaj-art-5e57fb1f97bd4d06b2e279cbe35651552025-08-20T02:36:45ZengSAGE PublishingSAGE Open Medicine2050-31212024-12-011210.1177/20503121241306957Weight bearing versus non-weight bearing total contact cast in the management of active Charcot foot: A systematic reviewRachna Prem0Vikramman Vignaraja1Thomas Lewis2Basil Budair3Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UKKing’s Foot and Ankle Unit, King’s College Hospital NHS Foundation Trust, London, UKKing’s Foot and Ankle Unit, King’s College Hospital NHS Foundation Trust, London, UKRoyal Orthopaedic Hospital, Birmingham, UKAim: Diabetic Charcot neuro-osteoarthropathy carries a significant worldwide disease burden including diabetic foot infection, ulceration and amputation. The current accepted standard of treatment during the active phase of Charcot neuro-osteoarthropathy is offloading with total contact casting; however, controversy remains regarding weight-bearing status during this period. Methods: A systematic review was performed following PRISMA guidelines of Pubmed, EMBASE, MEDLINE and the Cochrane central register of controlled trials for clinical studies from inception until June 2024 investigating weight-bearing and non-weight-bearing total contact casting for active Charcot neuro-osteoarthropathy. Results: Four hundred ninety-three studies were identified in the search strategy of which 5 studies met the inclusion criteria comprising 158 patients. These studies found that allowing patients to weight-bear during total contact casting does not have a negative impact on the healing process. There were no comparative studies between weight-bearing and non-weight-bearing total contact casting. Conclusions: There is limited evidence to support current practice of non-weight bearing in a total contact casting for active Charcot neuro-osteoarthropathy. Allowing patients to weight bear carries advantages to patient independence and quality of life. Further investigation with randomised control trial should be considered to investigate if weight bearing is associated with negative outcomes.https://doi.org/10.1177/20503121241306957
spellingShingle Rachna Prem
Vikramman Vignaraja
Thomas Lewis
Basil Budair
Weight bearing versus non-weight bearing total contact cast in the management of active Charcot foot: A systematic review
SAGE Open Medicine
title Weight bearing versus non-weight bearing total contact cast in the management of active Charcot foot: A systematic review
title_full Weight bearing versus non-weight bearing total contact cast in the management of active Charcot foot: A systematic review
title_fullStr Weight bearing versus non-weight bearing total contact cast in the management of active Charcot foot: A systematic review
title_full_unstemmed Weight bearing versus non-weight bearing total contact cast in the management of active Charcot foot: A systematic review
title_short Weight bearing versus non-weight bearing total contact cast in the management of active Charcot foot: A systematic review
title_sort weight bearing versus non weight bearing total contact cast in the management of active charcot foot a systematic review
url https://doi.org/10.1177/20503121241306957
work_keys_str_mv AT rachnaprem weightbearingversusnonweightbearingtotalcontactcastinthemanagementofactivecharcotfootasystematicreview
AT vikrammanvignaraja weightbearingversusnonweightbearingtotalcontactcastinthemanagementofactivecharcotfootasystematicreview
AT thomaslewis weightbearingversusnonweightbearingtotalcontactcastinthemanagementofactivecharcotfootasystematicreview
AT basilbudair weightbearingversusnonweightbearingtotalcontactcastinthemanagementofactivecharcotfootasystematicreview