PATHOGENESIS OF ACUTE DIABETIC CHARCOT ARTHROPATHY IN THE FOOT AND ANKLE: A COMPREHENSIVE LITERATURE REVIEW.

IF 2.1 Q3 ORTHOPEDICS
Orthopedic Reviews Pub Date : 2025-09-15 eCollection Date: 2025-01-01 DOI:10.52965/001c.144007
Osama Embaby, Afdhal Bin Asmadi, Aiman Binte Asmadi, Ahmed Haroun, Mahmoud Mersal, Mohamed Elalfy
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引用次数: 0

Abstract

Acute Diabetic Charcot Arthropathy (ADCA) is a severe complication of diabetes mellitus in patients with peripheral neuropathy, often misdiagnosed due to its similarity to cellulitis or deep vein thrombosis. This review examines ADCA's pathophysiology, emphasizing early diagnosis to prevent progression. We explore the roles of inflammatory cytokines (TNF-α, IL-1β, IL-6) in bone loss and joint degeneration, and investigate potential biomarkers and therapeutic targets in Wnt and IL-17 signaling pathways. The impact of metabolic imbalances and comorbidities on ADCA development is also discussed. Our analysis reveals ADCA's complex, multifactorial nature, involving neuropathy, inflammatory responses, and metabolic dysregulation. A comprehensive management approach aimed at achieving a stable, ulcer-free foot is essential to improve patient mobility and quality of life. We conclude that early intervention is crucial, focusing on reducing stress on affected regions in inflammatory stages. This is achieved by highlighting and implementing the advances in clinical practice, integration of recent research, education of patients on the importance of early intervention alongside developing improvements to current treatments.

急性糖尿病性踝关节病变的发病机制:综合文献综述。
急性糖尿病Charcot关节病(Acute Diabetic Charcot Arthropathy, ADCA)是糖尿病合并周围神经病变患者的严重并发症,常因其与蜂窝织炎或深静脉血栓相似而被误诊。本文综述了ADCA的病理生理学,强调早期诊断以防止进展。我们探索炎症因子(TNF-α, IL-1β, IL-6)在骨质流失和关节变性中的作用,并研究Wnt和IL-17信号通路中的潜在生物标志物和治疗靶点。代谢失衡和合并症对ADCA发展的影响也进行了讨论。我们的分析揭示了ADCA的复杂、多因素性质,涉及神经病变、炎症反应和代谢失调。旨在实现稳定、无溃疡足部的综合管理方法对于改善患者的活动能力和生活质量至关重要。我们得出结论,早期干预是至关重要的,重点是减少炎症阶段受影响区域的压力。这是通过强调和实施临床实践的进展、整合最新研究、对患者进行早期干预重要性的教育以及对当前治疗方法的改进来实现的。
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来源期刊
Orthopedic Reviews
Orthopedic Reviews ORTHOPEDICS-
CiteScore
2.70
自引率
4.80%
发文量
122
审稿时长
10 weeks
期刊介绍: Orthopedic Reviews is an Open Access, online-only, peer-reviewed journal that considers articles concerned with any aspect of orthopedics, as well as diagnosis and treatment, trauma, surgical procedures, arthroscopy, sports medicine, rehabilitation, pediatric and geriatric orthopedics. All bone-related molecular and cell biology, genetics, pathophysiology and epidemiology papers are also welcome. The journal publishes original articles, brief reports, reviews and case reports of general interest.
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