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

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.

Automated summary

The study aimed to compare functional outcomes, quality of life, and complications in two groups of Charcot-Marie-Tooth (CMT) patients based on the type of surgical operations. Patients who underwent joint preserving surgery showed better functional improvement and lower rates of complications compared to those who underwent joint sacrificing surgery. Early surgical intervention may be beneficial in delaying or preventing extensive reconstructive procedures in CMT patients.