Root cause is neuropathy causing tendon imbalance causing excessive forces combined with lack of protective sensation. Commonest is tight Achilles causing arch collapse and breakdown of midfoot

Laborde, JM et al, Preliminary results of primary gastrocnemius-solos recession for midfoot Charcot Arthropathy, Foot& Ankle Specialist, 2015; 2(2)_:140-4

doi 10.1177/1938640015607051

disrupted Chopart's joint ligaments, weakened foot intrinsic ms, tight achilles, taller drop, loss of arch support !!

Hi Dr LaBorde, hope u and yours are doing well.

Root Causes of Charcot for me are 4

1. Insensate neuropathy

2. Active Lifesyle

3. Underpinning Biomechanical Pathology

4. Concomitant factors such as weight, poor health, surgical failures, etc

Dennis (Dr Sha)

Amir:

You are discussing the known signs and symptoms of a Carcot Foot, not Root cause.

Dennis

I am retired so not working with Charcot patients or any patients for that matter. However, my clinical experience and interpretation of the emerging literature is that subtle equinus is the primary mechanical etiology of Charcot arthropathy of the midfoot. Equinus is the common pathway to this pathology. Please see my 2016 article, https://www.researchgate.net/publication/305660224_The_Split_Second_Effect_The_Mechanism_of_How_Equinus_Can_Damage_the_Human_Foot_and_Ankle, especially image 4 with the accompanying text. Thanks for a great question.

So, single root cause? I am all in for equinus!

Equinus is actually the primary biomechanical compensation for the inherited foot type pathology that is primary (as in functional foot typing - huge bias).

Peroneus longus and flexor hallucis longus adaptations and reduced 1st ray SERM-PERM Intervals prevent or reduce the equinus as primary care.

In advanced cases equinus must be dealt with but in pre-clinical Charcot, foot centering technology prevents the eventual Charcot bu denying the need for Equinus compensation.