Total knee arthroplasty in a patient with bilateral Charcot knees

Neuropathic arthropathy (Charcot joint) is a progressive and degenerative process resulting from underlying neurovascular and neurotraumatic deficits. Diabetes mellitus is now the most common cause of Charcot joint. A marked predilection for the tarsometatarsal, tarsal, and ankle joints occurs. Involvement of large weight-bearing joints such as the knee is rare. When the knee is involved, and conservative treatment fails, standard surgical intervention often involves arthrodesis. Arthroplasty is relatively contraindicated. The authors report a case of a 61-year-old, diabetic woman with bilateral Charcot knees who successfully completed a rehabilitation program and achieved independence after left knee arthrodesis and right total knee arthroplasty. (C) 1997 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.