{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:15:25Z","timestamp":1783509325525,"version":"3.55.0"},"reference-count":20,"publisher":"MDPI AG","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:p>Surgical reconstruction of the foot and ankle following degenerative changes secondary to Charcot neuroarthropathy poses a challenge due to both soft-tissue and osseous deformity. As a limb salvage procedure, this article aims to address such deformity with the goal of returning to a braceable limb without subsequent ulceration and infection. As this disease process affects both bone and soft tissue, surgical reconstruction should be directed to address osseous and ligamentous deformities that may contribute to postoperative failure. We present an algorithm to eliminate deforming forces, identify and stabilize at-risk and damaged anatomy, and stabilize the ankle joint to reduce the risk of postoperative progression to Charcot collapse of the ankle joint in individuals with midfoot Charcot neuroarthropathy. In conjunction with a multidisciplinary infection, perfusion, and bone metabolism assessment, this algorithm serves as comprehensive tool to evaluate and reconstruct midfoot Charcot collapse.<\/jats:p>","DOI":"10.7547\/23-120","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:58:49Z","timestamp":1756313929000},"source":"Crossref","is-referenced-by-count":0,"title":["A Surgical Decision-Making Algorithm for Reconstruction of Charcot Neuroarthropathy"],"prefix":"10.3390","volume":"115","author":[{"given":"Dominick","family":"Casciato","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, University of Maryland Medical Center, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Korey","family":"DuBois","sequence":"additional","affiliation":[{"name":"Brandywine Podiatry, Wilmington, Delaware."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Brandao","sequence":"additional","affiliation":[{"name":"Orthopedic Foot and Ankle Center, Worthington, Ohio."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Wynes","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Maryland Medical Center, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"B1","series-title":"The High Risk Foot in Diabetes Mellitus","first-page":"297","article-title":"Diabetic Neuropathic Osteoarthropathy","author":"Sanders LI","year":"1991","unstructured":"Sanders LI, Frykberg RG: \u201cDiabetic Neuropathic Osteoarthropathy\u201d in The High Risk Foot in Diabetes Mellitus, p 297, Churchill Livingston, New York, 1991."},{"key":"B2","series-title":"Curr Diab Rep","first-page":"430","article-title":"Theories concerning the pathogenesis of the acute Charcot foot suggest future therapy","volume":"5","author":"Jeffcoate WJ","year":"2005","unstructured":"Jeffcoate WJ: Theories concerning the pathogenesis of the acute Charcot foot suggest future therapy. Curr Diab Rep 5: 430, 2005."},{"key":"B3","series-title":"J Foot Ankle Surg","first-page":"301","article-title":"High incidence of recurrent ulceration and major amputations associated with Charcot foot","volume":"57","author":"Nilsen FA","year":"2018","unstructured":"Nilsen FA, Molund M, Hvaal KH: High incidence of recurrent ulceration and major amputations associated with Charcot foot. J Foot Ankle Surg 57: 301, 2018."},{"key":"B4","series-title":"Diabetes Care","first-page":"2123","article-title":"The Charcot foot in diabetes","volume":"34","author":"Rogers LC","year":"2011","unstructured":"Rogers LC, Frykberg RG, Armstrong DG, et al: The Charcot foot in diabetes. 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J Foot Ankle Surg 59: 1219, 2020."},{"key":"B9","series-title":"Foot Ankle Int","first-page":"18","article-title":"Clinical outcomes and complications of midfoot Charcot reconstruction with intramedullary beaming","volume":"40","author":"Ford SE","year":"2019","unstructured":"Ford SE, Cohen BE, Davis WH, et al: Clinical outcomes and complications of midfoot Charcot reconstruction with intramedullary beaming. Foot Ankle Int 40: 18, 2019."},{"key":"B10","series-title":"Foot Ankle Int","first-page":"644","article-title":"The development of a neuropathic ankle following successful correction of non-plantigrade charcot foot deformity","volume":"33","author":"Pinzur MS","year":"2012","unstructured":"Pinzur MS: The development of a neuropathic ankle following successful correction of non-plantigrade charcot foot deformity. Foot Ankle Int 33: 644, 2012."},{"key":"B11","series-title":"Clin Orthop Relat Res","first-page":"2869","article-title":"Is reconstruction of unstable midfoot Charcot neuroarthropathy cost effective from a US payer's perspective?","volume":"478","author":"Albright RH","year":"2020","unstructured":"Albright RH, Joseph RM, Wukich DK, et al: Is reconstruction of unstable midfoot Charcot neuroarthropathy cost effective from a US payer's perspective? Clin Orthop Relat Res 478: 2869, 2020."},{"key":"B12","series-title":"J Foot Ankle Surg","first-page":"1334","article-title":"A systematic review of intramedullary fixation in midfoot Charcot neuroarthropathy","volume":"61","author":"Wukich DK","year":"2022","unstructured":"Wukich DK, Liu GT, Johnson MJ, et al: A systematic review of intramedullary fixation in midfoot Charcot neuroarthropathy. J Foot Ankle Surg 61: 1334, 2022."},{"key":"B13","series-title":"J Clin Orthop Trauma","first-page":"59","article-title":"Surgical treatment of midfoot Charcot neuroarthropathy review of literature and our results after superconstruct reconstruction of midfoot Charcot neuroarthropathy","volume":"17","author":"Fr\u00f8kj\u00e6r J","year":"2021","unstructured":"Fr\u00f8kj\u00e6r J: Surgical treatment of midfoot Charcot neuroarthropathy review of literature and our results after superconstruct reconstruction of midfoot Charcot neuroarthropathy. J Clin Orthop Trauma 17: 59, 2021."},{"key":"B14","series-title":"Foot Ankle Int","first-page":"265","article-title":"Deformity and clinical outcomes following operative correction of Charcot foot: a new classification with implications for treatment","volume":"39","author":"Pinzur MS","year":"2018","unstructured":"Pinzur MS, Schiff AP: Deformity and clinical outcomes following operative correction of Charcot foot: a new classification with implications for treatment. Foot Ankle Int 39: 265, 2018."},{"key":"B15","series-title":"Clin Podiatr Med Surg","first-page":"33","article-title":"Surgical equinus correction for the diabetic Charcot foot: what the evidence reveals","volume":"34","author":"Capobianco CM","year":"2017","unstructured":"Capobianco CM: Surgical equinus correction for the diabetic Charcot foot: what the evidence reveals. 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J Foot Ankle Surg 61: 1076, 2022."},{"key":"B20","series-title":"J Foot Ankle Surg","first-page":"377","article-title":"Radiodensity analysis of lateral column superconstruct fixation sites in midfoot Charcot neuroarthropathy","volume":"62","author":"Casciato DJ","year":"2023","unstructured":"Casciato DJ, Stone R, Thompson J, et al: Radiodensity analysis of lateral column superconstruct fixation sites in midfoot Charcot neuroarthropathy. 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