{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:45:52Z","timestamp":1792291552542,"version":"4.4.0"},"reference-count":17,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The International Journal of Lower Extremity Wounds"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Charcot neuropathic arthropathy (CN) impacts peripheral lower extremity nerves, leading to joint destruction, and has a significant economic burden on the healthcare system. This economic burden is further exacerbated by the projected increase in diabetes mellitus cases over the coming decades, with a corresponding anticipated rise in CN. This study assesses CN management costs through a single institution retrospective chart review and cost-effectiveness through economic modeling by utilizing a well-established equation to determine the cost-effectiveness of conservative management. This retrospective chart review from a single academic center analyzed costs and outcomes for CN patients undergoing exostectomy, arthrodesis, major amputation, minor amputation, or casting from 2000-2022. This retrospective review analyzed 216 CN patients (average age 58, 54% male). Costs were $57\u2005949 for exostectomy, $149\u2005009 for arthrodesis, $40\u2005313 for major amputation, $55\u2005035 for minor amputation, $125\u2005851 for failed casting, and $8233 for casting. We conducted a break-even analysis that determined that intervention with casting was cost-effective compared to failed casting. Total contact casting is a cost-effective first-line treatment for CN, capable of managing non-advanced cases effectively and reducing the economic burden of surgical intervention. This study provides a critical framework for practitioners to assess cost-effectiveness in various institutional contexts.<\/jats:p>","DOI":"10.1177\/15347346251313652","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T01:37:06Z","timestamp":1738633026000},"page":"828-835","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Cost-Effective Modeling for Management Options in Charcot Neuroarthropathy"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7161-4970","authenticated-orcid":false,"given":"Andrea","family":"Shehaj","sequence":"first","affiliation":[{"name":"Penn State College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly M.","family":"Dopke","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul Wasay","family":"Paracha","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Mansfield","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela D.","family":"Pitcher","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlin","family":"Saloky","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation, Penn State Health, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Stauch","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation, Penn State Health, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erdi","family":"Ozdemir","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation, Penn State Health, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Aynardi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation, Penn State Health, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,2,3]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcte.2020.100239"},{"issue":"1","key":"e_1_3_3_3_2","article-title":"The Charcot joint in diabetes","volume":"13","author":"Klenerman L","year":"1996","unstructured":"Klenerman L. The Charcot joint in diabetes. 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Guidelines on offloading foot ulcers in persons with diabetes (IWGDF 2023 update). 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