Factors associated with the development of recurrent and contralateral Charcot neuroarthropathy in individuals with diabetes mellitus: A scoping review.

Introduction: 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.

Methods: 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.

Results: 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.

Conclusions: 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.