V.E.L.Milbourn^1,2, S.A.Bus^1,2, N.L.Petrova³, J.J.van Netten^1,2

1 Amsterdam UMC location, University of Amsterdam, Amsterdam, The Netherlands.
2 Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands.
3 King’s College Hospital NHS Foundation Trust, London, UK. Email:v.e.l.milbourn@amsterdamumc.nl

Background: The influence of biomechanical factors on Charcot neuro-osteoarthropathy (CNO) progression remains unclear. This study aims to: i) assess the correlation between peak plantar pressures (PPP) and remission durations in CNO patients, and ii) establish specific PPP thresholds as prognostic indicators for slow remission.

Method: A retrospective cohort analysis was performed on 17 patients with active CNO who underwent barefoot PPP measurements during walking using the Emed-X system at diagnosis. Baseline demographic, clinical, and biochemical data were collected, along with anatomical classification of bony involvement and remission duration. Spearman’s rho was utilized to determine the correlation between PPP and remission time. ROC curves identified PPP cutoffs predictive of slow remission exceeding 120 days.

Results: Participants had a mean age of 58 ± 13 years, with 11 females and 12 with Type 2 diabetes. A moderate correlation was observed between lateral mid-foot PPP and remission time (ρ=0.458, p=0.064). No significant correlations were found for medial mid-foot, hind foot, or total foot PPP (ρ ranging from -0.001 to 0.315). The predictive PPP threshold for slow remission was 141kPa in the lateral mid-foot and 600kPa for the total foot. Table 1 presents the prognostic performance metrics, indicated moderate predictive value, particularly for lateral mid-foot PPP threshold.

Conclusion: The moderate correlation between higher lateral mid-foot PPP and prolonged remission in CNO suggests its potential as a prognostic marker. The identified thresholds, particularly for lateral mid-foot, demonstrate moderate predictive value, highlighting their potential clinical relevance in predicting slow CNO remission. Further investigation is warranted to validate these findings.