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Functional results and quality of life after joint preserving or sacrificing surgery in Charcot-Marie-Tooth foot deformities

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Abstract

Introduction

The purpose of this study was to assess the functional results, quality of life, and complications in two groups of Charcot-Marie-Tooth (CMT) patients according to the type of surgical operations, joint preserving, or joint sacrificing surgery.

Methods

Fifty-two feet in forty-six patients with CMT who had undergone surgical deformity correction were divided into two groups based on the main surgical procedure for the correction: Class I (joint preserving surgery) and class II (joint sacrificing surgery). Foot ankle disability index (FADI) and short form 12 version 2 (SF12V2) were documented pre-operative and 12 months post-operative. The complications of both groups were monitored with a mean follow-up time of 20.5 months (range, 13–71.5).

Results

After surgical treatment, FADI scores showed differences (p=0.005) between both groups. The functional improvement was 29 (20–46; p<0.001) in class I and 10 (2–36; p=0.001) in class II. The patients in both groups acquired a better quality of life as demonstrated in physical component summary of SF12 but without statistically difference. Three feet needed reintervention in class I (two for cavovarus recurrence and one for hallux flexus) at the end of follow-up. In contrast, five feet needed a new operation for cavovarus recurrence, claw toes recurrence, and ankle osteoarthritis after the progression of the condition.

Discussion

An early surgical intervention to neutralize the deforming forces in CMT patients could be a useful strategy to delay or prevent the need for extensive reconstruction and potential future complications.

Conclusion

Based on the type of surgical intervention in CMT patients, the joint preserving surgery in addition to soft tissue balancing procedures obtained better functional outcomes and lower rate of complications when compared to the group of joint sacrificing surgery.

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Data Availability

Not applicable

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Acknowledgements

We thank the participation of Eloisa Rubio Pérez (Statistics and Research Methodology Unit) for her help with methods and statistical analysis.

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Author information

Authors and Affiliations

  1. Foot Ankle Unit, University Hospital Virgen del Rocío, Seville, Spain

    Sergio Tejero

  2. University of Seville, Seville, Spain

    Sergio Tejero

  3. University Hospital Virgen del Rocío, Seville, Spain

    Juan Chans-Veres

  4. Seville, Spain

    Andrés Carranza-Bencano

  5. Gerge Eliot Hospital, Nuneaton, UK

    Ahmed E Galhoum

  6. Hospital Clinic, Barcelona, Spain

    Daniel Poggio

  7. Schmerzklinik Basel, Genolier Swiss Medical Network GSMN, Basel, Switzerland

    Victor Valderrábano

  8. University Hospital La Laguna, Canarias, Spain

    Mario Herrera-Pérez

Authors
  1. Sergio Tejero
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  4. Ahmed E Galhoum
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  5. Daniel Poggio
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  7. Mario Herrera-Pérez
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Sergio Tejero. The first draft of the manuscript was written by Sergio Tejero, and all authors commented on the previous versions of the manuscript. All authors read and approved the final manuscript.

• Conceptualization: Sergio Tejero and Mario Herrera-Pérez

• Methodology: Sergio Tejero and Juan Chans-Veres

• Formal analysis and investigation: Sergio Tejero and Andrés Carranza-Bencano

• Writing - original draft preparation: Sergio Tejero

• Writing - review and editing: Ahmed Galoum, Daniel Poggio, and Victor Valderrabano

• Funding acquisition: Not applicable

• Resources: Not applicable

• Supervision: Ahmed Galoum, Daniel Poggio, and Victor Valderrabano

• Validation: Sergio Tejero and Juan Chans-Veres

• Visualization: Sergio Tejero, Juan Chans-Veres and Mario Herrera-Pérez.

Corresponding author

Correspondence to Sergio Tejero.

Ethics declarations

Ethics approval

Ethical approval for this study was obtained from our institution’s ethical review committee (CEIC 1925-N-19).

Consent to participate

The authors affirm that all individuals consented to participate in this study.

Consent for publication

The authors affirm that participants provided informed consent for the publication of their data and photographs.

Competing interests

The authors declare no competing interests.

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Level of evidence: Level IV, case series

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Tejero, S., Chans-Veres, J., Carranza-Bencano, A. et al. Functional results and quality of life after joint preserving or sacrificing surgery in Charcot-Marie-Tooth foot deformities. International Orthopaedics (SICOT) 45, 2569–2578 (2021). https://doi.org/10.1007/s00264-021-04978-7

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  • DOI: https://doi.org/10.1007/s00264-021-04978-7

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