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Background <p>Charcot neuroarthropathy (CN) is a rare musculoskeletal disorder caused by peripheral neuropathy, predominantly affecting the forefoot and ankle joints in diabetic patients. While more common in type 2 diabetes, type 1 diabetes-associated CN carries high risks of disability and mortality due to delayed diagnosis and nonspecific pathophysiology. Knee joint CN in type 1 diabetes remains exceptionally rare, with limited reports on standardized management—particularly regarding knee arthroplasty outcomes.</p> Case Presentation <p>We report two female type 1 diabetes patients with knee joint CN. Both presented with poorly controlled hyperglycemia (blood glucose &gt; 20 mmol/L) and elevated HbA1c. Each underwent total knee arthroplasty (TKA); one patient additionally received autologous bone grafting with titanium mesh screw fixation for severe bone defects, Intraoperative pathological examination was performed in all cases to rule out infection.</p> Conclusion <p>These cases highlight the complexity of managing knee CN in type 1 diabetes. TKA represents a viable intervention, though outcomes may vary based on surgical adjuncts like bone grafting. This report, contextualized with a literature review, underscores the need for individualized approaches in this high-risk population.</p>

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Hinged total knee arthroplasty in two female patients with type 1 diabetes-associated charcot neuroarthropathy: case reports and a review of the literature series

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月29日

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  • Chao Lei,
  • Wen-zhou Huang,
  • Lin Mei,
  • Kuo Sun,
  • Xin-zhan Mao

摘要

Background

Charcot neuroarthropathy (CN) is a rare musculoskeletal disorder caused by peripheral neuropathy, predominantly affecting the forefoot and ankle joints in diabetic patients. While more common in type 2 diabetes, type 1 diabetes-associated CN carries high risks of disability and mortality due to delayed diagnosis and nonspecific pathophysiology. Knee joint CN in type 1 diabetes remains exceptionally rare, with limited reports on standardized management—particularly regarding knee arthroplasty outcomes.

Case Presentation

We report two female type 1 diabetes patients with knee joint CN. Both presented with poorly controlled hyperglycemia (blood glucose > 20 mmol/L) and elevated HbA1c. Each underwent total knee arthroplasty (TKA); one patient additionally received autologous bone grafting with titanium mesh screw fixation for severe bone defects, Intraoperative pathological examination was performed in all cases to rule out infection.

Conclusion

These cases highlight the complexity of managing knee CN in type 1 diabetes. TKA represents a viable intervention, though outcomes may vary based on surgical adjuncts like bone grafting. This report, contextualized with a literature review, underscores the need for individualized approaches in this high-risk population.