Abstract
BACKGROUND AND AIMS: In 2023 the International Working Group of the Diabetic Foot (IWGDF) published definitions for the diagnosis, remission and relapse of active Charcot neuro-osteoarthropathy (CN). Until 2023 authors had used varied definitions to identify the stages of CN making comparisons difficult. The aim of the current study was to illustrate variation in definitions used before 2023 and to encourage consistent terminology in future publications. METHODS: Searches were conducted in OVID, Pubmed and CINAHL. Studies were included if they had a minimum of 10 participants and reported the outcomes of CN in conservative or pharmacological treatments in people with diabetes and CN. Included study designs were randomised controlled trials, cohort studies, non-randomised controlled trials, case-controls and case series. We excluded studies of surgical treatment of CN. Data collected included location of the study, study design and population. Definitions of each stage were compared to the IWGDF definitions through a scoring system. RESULTS: We screened 1758 titles, 143 abstracts and 63 full texts. We included 37 studies from 20 different countries. Scores comparing the studies' definitions to the published IWGDF guidelines for definitions ranged from a similarity of 17%-100%. Six studies scored 100% with 31 studies missing aspects of the IWGDF definitions. CONCLUSION: Authors should use standardised definitions of the stages of CN to allow comparisons between studies to be accurately made. More work is needed to assess the variation in terminology within studies with CN treated surgically.