Early Treatment of Acute Stage 0/1 Diabetic Charcot Foot Can Avoid Major Amputations at One Year

background: If unrecognized, charcot neuro-osteoarthropathy (CNO) can be a devastating complication of diabetes. methods: the aim of this retrospective study was to evaluate the outcomes in a cohort of diabetic patients diagnosed with active CNO managed in a tertiary level diabetic foot clinic (DFC). we included consecutive patients with active CNO, stage 0-1, according to the eichenholtz-shibata classification, who were referred from 1 January 2019 to 27 september 2022. diagnosis of CNO was based on clinical signs and imaging (X-rays and magnetic resonance). all patients were completely offloaded by a total-contact cast (TCC) or removable knee-high device. each patient was closely monitored monthly until CNO remission or another outcome. at 12 months of follow-up, the following outcomes were analyzed: remission, time to remission, major amputations (any above the ankle), and surgical indication. results: forty-three patients were included. the mean age was 57.6 +/- 10.8 years; 65% were males and 88.4% had type 2 diabetes, with a mean duration of 20.6 +/- 9.9 years. at baseline, 32.6% was affected by peripheral artery disease. complete remission was recorded in 40/43 patients (93%), with a mean time to remission of 5.6 +/- 1.5 months; major amputation and surgical indication occurred, respectively in 1/43 patients (2.3%) and 3/43 patients (7%). conclusions: early treatment of active Stage 0/1 CNO leads to high rates of remission and limb salvage.