HISTOPATHOLOGY OF CHARCOT ARTHROPATHY

The aim of the research was to identify structural changes in tissues of the lower limbs in patients with Charcot foot. Tarsus bone fragments and surrounding soft tissues were obtained during corrective osteotomy (n = 2); sural nerve fragments were harvested from patients who underwent amputations due to infectious complications or loss of function (n = 4). Histological methods and ultra-thin sections for electron microscopy were used. Severe pathological changes such as significantly thickened basal membrane, endothelium hyperplasia, and lumen occlusion were observed in the microcirculatory vessels. Sural nerve structure was characterized by irreversible pathomorphological changes including massive mosaic demyelination, markedly reduced number of axis-cylinders, and lemmocyte dystrophy and loss. Bone tissue necrosis, cortical bone layer thinning, and impaired reparative osteogenesis were observed in specimen and were caused by microcirculatory dysfunction. Surrounding tissues were characterized by oedema and intercellular matrix damage, collagen fiber fragmentation, muscle fiber and connective tissue cell death.