Charcot foot, characterized by progressive destructive damage to bone, soft tissue and tendons, involving joint dislocation in the ankle and foot, is a complication of diabetes that is still poorly understood by patients and caregivers. The clinical signs are non-specific and it is therefore largely underestimated due to a delay in diagnosis/lack of diagnosis.This study will be on a prospective multicenter cohort of patients with chronic Charcot's foot in France to evaluate the evolution of quality of life at 2 years, as well as predictive factors in order to better identify subjects with the worst outcome among this population. Our hypothesis is that, in patients with chronic Charcot foot, the deterioration in quality of life over time is primarily related to loss of foot and ankle functionality, foot and ankle deformity and the presence of foot wounds/comorbidities/severe diabetic complications.
Diabetes mellitus is a chronic disease, representing a major public health problem. An estimated 537 million people have diabetes. Charcot foot, also known as neurogenic osteoarthropathy (NAO), is one of the complications of diabetes secondary to diabetic neuropathy. It is characterized by progressive destructive damage to bone, soft tissue and tendons, involving joint dislocation in the ankle and foot. Charcot foot is a complication of diabetes that is still poorly understood by patients and caregivers, with non-specific clinical signs. It is therefore largely underestimated, since it is estimated that there is a delay in diagnosis or a lack of diagnosis in approximately 25% of cases. The objective of our study is to conduct a prospective multicenter cohort of patients with chronic Charcot's foot in France in order to evaluate the evolution of the quality of life at 2 years, as well as its predictive factors. In this way, we will be better able to identify the subjects with the worst outcome among the chronic Charcot foot population. Our hypothesis is that the deterioration in quality of life over time in patients with chronic Charcot foot is primarily related to loss of foot and ankle functionality, foot and ankle deformity, the presence of foot wounds and/or comorbidities or severe diabetic complications.
Study Type
OBSERVATIONAL
Enrollment
150
The SF-36, FAAM-F, PHQ-9, PHQ-2 and the simplified version of the EPICES score questionnaire will all be filled in by the patients.
Centre Hospitalier de Boulogne-sur-Mer
Boulogne-sur-Mer, Pas-de-Calais, France
NOT_YET_RECRUITINGGroupement Hospitalier Est, Hôpital Cardiologique Service de Diabétologie 28 Av du Doyen Lépine
Bron, France
NOT_YET_RECRUITINGCH Sud Francilien Service de Diabétologie 40 Avenue Serge Dassault
Corbeil-Essonnes, France
NOT_YET_RECRUITINGCHU de Grenoble Service d'Endocrinologie Allée des Sablons Les écrins
Grenoble, France
NOT_YET_RECRUITINGHôpital Hôtel dieu Service d'Endocrinologie 26 rue d'Harfleur
Le Creusot, France
NOT_YET_RECRUITINGCHU Bicêtre Service d'Endocrinologie et Maladies de la reproduction 78 rue du Général Leclerc
Le Kremlin-Bicêtre, France
RECRUITINGCH de Lens Unité de Diabétologie-Endocrinologie- Nutrition-Obésité Centre Hospitalier Dr SCHAFFNER 99 rte de La Bassée,
Lens, France
RECRUITINGCHRU de Lille Service d'Endocrinologie Diabétologie et Métabolisme, Hôpital Claude Huriez, Rue Polonovski
Lille, France
NOT_YET_RECRUITINGCHU de la CONCEPTION Service de Nutrition, Diabétologie, Obésité médicale, chirurgicale 47 Bd Baille
Marseille, France
NOT_YET_RECRUITINGCHU de Montpellier Service des Maladies métaboliques 371 av. Doyen Giraud
Montpellier, France
RECRUITING...and 7 more locations
Results of the SF36 questionnaire at inclusion
The SF-36 questionnaire is a quality of life questionnaire that includes 36 questions divided into 8 different categories (physical functioning, limitations due to physical condition, physical pain, perceived health, vitality, social functioning or well-being, limitations due to mental condition, mental health). These 8 dimensions are used to calculate two scores on the quality of life of individuals: the physical composite score and the mental composite score. The higher the score, the greater the capacity. It is self-administered and takes less than 10 minutes. Higher scores indicate better quality of life. The French version has been validated and has satisfactory psychometric properties. Score from 0 to 100.
Time frame: Day 0
Results of the FAAM-F questionnaire at inclusion
The FAAM is a self-administered questionnaire that measures physical function of the foot and ankle. It is adapted and validated in the evaluation of diabetic foot disease. It consists of an assessment of activity of daily living and a sports assessment. The FAAM has been translated and validated in French. Score from 0 to 100.
Time frame: Day 0
Results of the SF36 questionnaire at Month 12
The SF-36 questionnaire is a quality of life questionnaire that includes 36 questions divided into 8 different categories (physical functioning, limitations due to physical condition, physical pain, perceived health, vitality, social functioning or well-being, limitations due to mental condition, mental health). These 8 dimensions are used to calculate two scores on the quality of life of individuals: the physical composite score and the mental composite score. The higher the score, the greater the capacity. It is self-administered and takes less than 10 minutes. Higher scores indicate better quality of life. The French version has been validated and has satisfactory psychometric properties. Score from 0 to 100.
Time frame: Month 12
Results of the FAAM-F questionnaire at Month 12
The FAAM is a self-administered questionnaire that measures physical function of the foot and ankle. It is adapted and validated in the evaluation of diabetic foot disease. It consists of an assessment of activity of daily living and a sports assessment. The FAAM has been translated and validated in French. Score from 0 to 100.
Time frame: Month 12
Results of the SF36 questionnaire at Month 24
The SF-36 questionnaire is a quality of life questionnaire that includes 36 questions divided into 8 different categories (physical functioning, limitations due to physical condition, physical pain, perceived health, vitality, social functioning or well-being, limitations due to mental condition, mental health). These 8 dimensions are used to calculate two scores on the quality of life of individuals: the physical composite score and the mental composite score. The higher the score, the greater the capacity. It is self-administered and takes less than 10 minutes. Higher scores indicate better quality of life. The French version has been validated and has satisfactory psychometric properties. Score from 0 to 100.
Time frame: Month 24
Results of the FAAM-F questionnaire at Month 24
The FAAM is a self-administered questionnaire that measures physical function of the foot and ankle. It is adapted and validated in the evaluation of diabetic foot disease. It consists of an assessment of activity of daily living and a sports assessment. The FAAM has been translated and validated in French. Score from 0 to 100.
Time frame: Month 24
A. Evolution of X-ray measurements of bone and joint deformity of the foot. Lisfranc metatarsal misalignment (Méary's Line)
In normal metatarsal alignment, the lateral border of the 1st metatarsal is aligned with lateral border of 1st (medial) cuneiform. The medial border of 2nd metatarsal is aligned with the medial border of 2nd (intermediate) cuneiform.The medial border of the 3rd (lateral) cuneiform should align with the medial border of the 3rd metatarsal. The lateral border of the 3rd (lateral) cuneiform should align with the lateral border of the 3rd metatarsal. The medial border of the 4th metatarsal is aligned with the medial border of the cuboid. The lateral margin of the 5th metatarsal can project lateral to cuboid by up to 3 mm on oblique. This alignment is known as the Méary Line and is assessed in front view.
Time frame: Day 0
A. Evolution of X-ray measurements of bone and joint deformity of the foot. Lisfranc metatarsal misalignment (Méary's Line)
In normal metatarsal alignment, the lateral border of the 1st metatarsal is aligned with lateral border of 1st (medial) cuneiform. The medial border of 2nd metatarsal is aligned with the medial border of 2nd (intermediate) cuneiform.The medial border of the 3rd (lateral) cuneiform should align with the medial border of the 3rd metatarsal. The lateral border of the 3rd (lateral) cuneiform should align with the lateral border of the 3rd metatarsal. The medial border of the 4th metatarsal is aligned with the medial border of the cuboid. The lateral margin of the 5th metatarsal can project lateral to cuboid by up to 3 mm on oblique. This alignment is known as the Méary Line and is assessed in front view.
Time frame: Month 12
A. Evolution of X-ray measurements of bone and joint deformity of the foot. Lisfranc metatarsal misalignment (Méary's Line)
In normal metatarsal alignment, the lateral border of the 1st metatarsal is aligned with lateral border of 1st (medial) cuneiform. The medial border of 2nd metatarsal is aligned with the medial border of 2nd (intermediate) cuneiform.The medial border of the 3rd (lateral) cuneiform should align with the medial border of the 3rd metatarsal. The lateral border of the 3rd (lateral) cuneiform should align with the lateral border of the 3rd metatarsal. The medial border of the 4th metatarsal is aligned with the medial border of the cuboid. The lateral margin of the 5th metatarsal can project lateral to cuboid by up to 3 mm on oblique. This alignment is known as the Méary Line and is assessed in front view.
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Time frame: Month 24
A. Evolution of the radiologic measurements of bone and joint deformity of the foot: Méary's angle.
Meary's angle (the angle between the line from the center of the talus body, intersecting the neck and head of the talus, and the line through the longitudinal axis of the 1st metatarsal) will be measured in profile view, in degrees. The normal value is about 0°.
Time frame: Day 0
A. Evolution of the radiologic measurements of bone and joint deformity of the foot: Méary's angle.
Meary's angle (the angle between the line from the center of the talus body, intersecting the neck and head of the talus, and the line through the longitudinal axis of the 1st metatarsal) will be measured in profile view, in degrees. The normal value is about 0°.
Time frame: Month 12
A. Evolution of the radiologic measurements of bone and joint deformity of the foot: Méary's angle.
Meary's angle (the angle between the line from the center of the talus body, intersecting the neck and head of the talus, and the line through the longitudinal axis of the 1st metatarsal) will be measured in profile view, in degrees. The normal value is about 0°.
Time frame: Month 24
A. Evolution of the radiologic measurements of bone and joint deformity of the foot. Calcaneal slope
The calcaneal slope angle (line tangent to the inferior cortex of the calcaneus (angle between this line and a horizontal line) will be measured in degrees. Normal values are10-30° on the profile X-ray.
Time frame: Day 0
A. Evolution of the radiologic measurements of bone and joint deformity of the foot. Calcaneal slope
The calcaneal slope angle (line tangent to the inferior cortex of the calcaneus (angle between this line and a horizontal line) will be measured in degrees. Normal values are10-30° on the profile X-ray.
Time frame: Month 12
A. Evolution of the radiologic measurements of bone and joint deformity of the foot. Calcaneal slope
The calcaneal slope angle (line tangent to the inferior cortex of the calcaneus (angle between this line and a horizontal line) will be measured in degrees. Normal values are10-30° on the profile X-ray.
Time frame: Month 24
A. Evolution of the radiologic measurements of bone and joint deformity of the foot. Djian Annonier angle
The Djian-Annonier angle will be measured (line between lower point of the talo-navicular joint and lower point of the medial sesamoid bone at the hallux). Line tangent to the inferior surface of the calcaneus. Normal value: 120-130° on profile X-ray.
Time frame: Day 0
A. Evolution of the radiologic measurements of bone and joint deformity of the foot. Djian Annonier angle
The Djian-Annonier angle will be measured (line between lower point of the talo-navicular joint and lower point of the medial sesamoid bone at the hallux). Line tangent to the inferior surface of the calcaneus. Normal value: 120-130° on profile X-ray.
Time frame: Month 12
A. Evolution of the radiologic measurements of bone and joint deformity of the foot. Djian Annonier angle
The Djian-Annonier angle will be measured (line between lower point of the talo-navicular joint and lower point of the medial sesamoid bone at the hallux). Line tangent to the inferior surface of the calcaneus. Normal value: 120-130° on profile X-ray.
Time frame: Month 24
A. Evolution of the radiologic measurements of bone and joint deformity of the foot. Rearfoot alignment
The rearfoot alignment angle i.e. angle between the axis of the tibia and the line between the middle of the plantar support plane and the middle of talus will be measured in degrees..
Time frame: Day 0
A. Evolution of the radiologic measurements of bone and joint deformity of the foot. Rearfoot alignment
The rearfoot alignment angle i.e. angle between the axis of the tibia and the line between the middle of the plantar support plane and the middle of talus will be measured in degrees..
Time frame: Month 12
A. Evolution of the radiologic measurements of bone and joint deformity of the foot. Rearfoot alignment
The rearfoot alignment angle i.e. angle between the axis of the tibia and the line between the middle of the plantar support plane and the middle of talus will be measured in degrees..
Time frame: Month 24
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Retinopathy
YES/NO
Time frame: Month 24
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Retinopathy
YES/NO
Time frame: Month 12
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Peripheral vegetative neuropathy.
YES/NO
Time frame: Day 0
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Peripheral vegetative neuropathy.
YES/NO
Time frame: Month 12
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Peripheral vegetative neuropathy.
YES/NO
Time frame: Month 24
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Nephropathy.
YES/NO
Time frame: Day 0
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Nephropathy.
YES/NO
Time frame: Month 12
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Nephropathy.
YES/NO
Time frame: Month 24
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Lower extremity arteriopathy
YES/NO
Time frame: Day 0
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Lower extremity arteriopathy
YES/NO
Time frame: Month 12
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Lower extremity arteriopathy
YES/NO
Time frame: Month 24
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Supra-aortic trunk involvement
YES/NO
Time frame: Day 0
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Supra-aortic trunk involvement
YES/NO
Time frame: Month 12
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Supra-aortic trunk involvement
YES/NO
Time frame: Month 24
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Coronary artery disease
YES/NO
Time frame: Day 0
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Coronary artery disease
YES/NO
Time frame: Month 12
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Coronary artery disease
YES/NO
Time frame: Month 24
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Heart failure
YES/NO (measured according to a Left Ventricle Ejection Fraction of less than 50%)
Time frame: Day 0
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Heart failure
YES/NO (measured according to a Left Ventricle Ejection Fraction of less than 50%)
Time frame: Month 12
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Heart failure
YES/NO (measured according to a Left Ventricle Ejection Fraction of less than 50%)
Time frame: Month 24
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. History of strokes
YES/NO
Time frame: Day 0
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. History of strokes
YES/NO
Time frame: Month 12
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. History of strokes
YES/NO
Time frame: Month 24
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Arterial hypertension
Pressure over 140/90mmHg : YES/NO
Time frame: Day 0
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Arterial hypertension
Pressure over 140/90mmHg : YES/NO
Time frame: Month 12
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Arterial hypertension
Pressure over 140/90mmHg : YES/NO
Time frame: Month 24
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Smoking
Does the patient smoke : YES/NO
Time frame: Day 0
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Smoking
Does the patient smoke : YES/NO
Time frame: Month 12
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Smoking
Does the patient smoke : YES/NO
Time frame: Month 24
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Alcohol status
Does the patient drink more than 3 glasses of alcohol per day : YES/NO alcohol status Charlson score
Time frame: Day 0
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Alcohol status
Does the patient drink more than 3 glasses of alcohol per day : YES/NO alcohol status Charlson score
Time frame: Month 12
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Alcohol status
Does the patient drink more than 3 glasses of alcohol per day : YES/NO alcohol status Charlson score
Time frame: Month 24
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Charlson Comorbidity Index
The Charlson comorbidity index predicts the 1-year mortality for patient with a range of comorbid conditions, e.g. heart disease, AIDS, or cancer (a total of 22 conditions). Each condition is assigned a score of 1, 2, 3, or 6, depending on the risk of dying associated with each one. Scores are summed to provide a total score to predict mortality. Clinical conditions and associated scores are as follows: 1. each: Myocardial infarct, congestive heart failure, peripheral vascular disease, dementia, cerebrovascular disease, chronic lung disease, connective tissue disease, ulcer, chronic liver disease, diabetes. 2. each: Hemiplegia, moderate or severe kidney disease, diabetes with end organ damage, tumor, leukemia, lymphoma. 3. each: Moderate or severe liver disease. 6 each: Malignant tumor, metastasis, AIDS.
Time frame: Day 0
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Charlson Comorbidity Index
The Charlson comorbidity index predicts the 1-year mortality for patient with a range of comorbid conditions, e.g. heart disease, AIDS, or cancer (a total of 22 conditions). Each condition is assigned a score of 1, 2, 3, or 6, depending on the risk of dying associated with each one. Scores are summed to provide a total score to predict mortality. Clinical conditions and associated scores are as follows: 1. each: Myocardial infarct, congestive heart failure, peripheral vascular disease, dementia, cerebrovascular disease, chronic lung disease, connective tissue disease, ulcer, chronic liver disease, diabetes. 2. each: Hemiplegia, moderate or severe kidney disease, diabetes with end organ damage, tumor, leukemia, lymphoma. 3. each: Moderate or severe liver disease. 6 each: Malignant tumor, metastasis, AIDS.
Time frame: Month 12
B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Charlson Comorbidity Index
The Charlson comorbidity index predicts the 1-year mortality for patient with a range of comorbid conditions, e.g. heart disease, AIDS, or cancer (a total of 22 conditions). Each condition is assigned a score of 1, 2, 3, or 6, depending on the risk of dying associated with each one. Scores are summed to provide a total score to predict mortality. Clinical conditions and associated scores are as follows: 1. each: Myocardial infarct, congestive heart failure, peripheral vascular disease, dementia, cerebrovascular disease, chronic lung disease, connective tissue disease, ulcer, chronic liver disease, diabetes. 2. each: Hemiplegia, moderate or severe kidney disease, diabetes with end organ damage, tumor, leukemia, lymphoma. 3. each: Moderate or severe liver disease. 6 each: Malignant tumor, metastasis, AIDS.
Time frame: Month 24
C. Medical and/or surgical treatment for Charcot foot.
All medical and/or surgical treatment for Charcot foot will be recorded.
Time frame: Day 0
C. Medical and/or surgical treatment for Charcot foot.
All medical and/or surgical treatment for Charcot foot will be recorded.
Time frame: Month 12
C. Medical and/or surgical treatment for Charcot foot.
All medical and/or surgical treatment for Charcot foot will be recorded.
Time frame: Month 24
D. Incidence of hospitalization
The number of hospitalizations (if any) will be noted.
Time frame: Month 12
D. Incidence of hospitalization
The number of hospitalizations (if any) will be noted.
Time frame: Month 24
E. Presence of a wound/wounds
YES/NO and number thereof.
Time frame: Month 12
E. Presence of a wound/wounds
YES/NO and number thereof.
Time frame: Month 24
E. Presence of an infection
YES/NO
Time frame: Month 12
E. Presence of an infection
YES/NO
Time frame: Month 24
F. Presence of an amputation at inclusion
YES/NO (or, if planned, time to amputation in days).
Time frame: Day 0
G. Estimated incidence of amputations
YES/NO (or, if planned, time to amputation in days).
Time frame: Month 12
G. Presence of an amputation
YES/NO (or, if planned, time to amputation in days).
Time frame: Month 24
H. Precarity of patients with chronic Charcot foot.
The EPICES (Evaluation de la précarité et des inégalités de santé dans les Centres d'examens) score is an individual indicator of precariousness that takes into account the multidimensional nature of precariousness. The main interest of the EPICES score is to capture populations which, while not covered by traditional administrative indicators of precariousness present the same health risks. A threshold of 30 is considered as precariousness according to EPICES.
Time frame: Day 0
H. Precarity of patients with chronic Charcot foot.
The EPICES (Evaluation de la précarité et des inégalités de santé dans les Centres d'examens) score is an individual indicator of precariousness that takes into account the multidimensional nature of precariousness. The main interest of the EPICES score is to capture populations which, while not covered by traditional administrative indicators of precariousness present the same health risks. A threshold of 30 is considered as precariousness according to EPICES.
Time frame: Month 12
H. Precarity of patients with chronic Charcot foot.
The EPICES (Evaluation de la précarité et des inégalités de santé dans les Centres d'examens) score is an individual indicator of precariousness that takes into account the multidimensional nature of precariousness. The main interest of the EPICES score is to capture populations which, while not covered by traditional administrative indicators of precariousness present the same health risks. A threshold of 30 is considered as precariousness according to EPICES.
Time frame: Month 24
I. Depression according to the PHQ-2 self-questionnaire
The purpose of the PHQ-2 is to screen for depression in a "first-step" approach. there are 2 questions referring to the patient's feelings over the previous 2 weeks ( 0 = Not at all and 3 = Nearly every day). A PHQ-2 score ranges from 0-6 and a score of 3 is the optimal cutoff point when using the PHQ-2 to screen for depression. If the score is 3 or greater, major depressive disorder is likely and the PHQ-9 questionnaire should then be used.
Time frame: Day 0
I. Depression according to the PHQ-2 self-questionnaire
The purpose of the PHQ-2 is to screen for depression in a "first-step" approach. there are 2 questions referring to the patient's feelings over the previous 2 weeks ( 0 = Not at all and 3 = Nearly every day). A PHQ-2 score ranges from 0-6 and a score of 3 is the optimal cutoff point when using the PHQ-2 to screen for depression. If the score is 3 or greater, major depressive disorder is likely and the PHQ-9 questionnaire should then be used.
Time frame: Month 24
I. Depression according to the PHQ-2 self-questionnaire
The purpose of the PHQ-2 is to screen for depression in a "first-step" approach. there are 2 questions referring to the patient's feelings over the previous 2 weeks ( 0 = Not at all and 3 = Nearly every day). A PHQ-2 score ranges from 0-6 and a score of 3 is the optimal cutoff point when using the PHQ-2 to screen for depression. If the score is 3 or greater, major depressive disorder is likely and the PHQ-9 questionnaire should then be used.
Time frame: Month 12
I. Depression according to the PHQ-9 self-questionnaire
The PHQ-9 questionnaire is a set of 9 questions referring to the patients feelings over the previous 2 weeks with answers ranging from 0 = Not at all to 3 = Nearly every day. Interpreted as follows : 1-4 = minimum depression ; 5-9 = slight depression;10-14 = moderate depression;15-19 = moderately severe depression and 20-27 = severe depression.
Time frame: Day 0
I. Depression according to the PHQ-9 self-questionnaire
The PHQ-9 questionnaire is a set of 9 questions referring to the patients feelings over the previous 2 weeks with answers ranging from 0 = Not at all to 3 = Nearly every day. Interpreted as follows : 1-4 = minimum depression ; 5-9 = slight depression;10-14 = moderate depression;15-19 = moderately severe depression and 20-27 = severe depression.
Time frame: Month 12
I. Depression according to the PHQ-9 self-questionnaire
The PHQ-9 questionnaire is a set of 9 questions referring to the patients feelings over the previous 2 weeks with answers ranging from 0 = Not at all to 3 = Nearly every day. Interpreted as follows : 1-4 = minimum depression ; 5-9 = slight depression;10-14 = moderate depression;15-19 = moderately severe depression and 20-27 = severe depression.
Time frame: Month 24
J. Mortality rate
Vital status (dead/alive)
Time frame: Month 12
J. Mortality rate
Vital status (dead/alive)
Time frame: Month 24
K. Sanders Classification of the Charcot Foot
The Sanders classification will be used to assess the degree of damage to the patient's foot as follows : Sanders I = Metatarsophalangeal involvement (forefoot) Sanders II= Tarsometatarsal joint involvement Sanders III= Tarsal joints involvement Sanders IV= Ankle involvement Sanders V= Posterior calcaneus involvement (tuberosity of the calcaneus, avulsion of the Achilles tendon) and all information will be recorded for the evaluation of the patient's quality of life.
Time frame: Day 0
K. Sanders Classification of the Charcot Foot
The Sanders classification will be used to assess the degree of damage to the patient's foot as follows : Sanders I = Metatarsophalangeal involvement (forefoot) Sanders II= Tarsometatarsal joint involvement Sanders III= Tarsal joints involvement Sanders IV= Ankle involvement Sanders V= Posterior calcaneus involvement (tuberosity of the calcaneus, avulsion of the Achilles tendon) and all information will be recorded for the evaluation of the patient's quality of life.
Time frame: Month 12