Healing of Charcot's joint by pamidronate infusion

Treatment of Charcot's joints remains difficult, and involves prolonged per iods without weightbearing, immobilization, and surgical salvage procedures to avoid amputation. We describe the efficacy of pamidronate in treating a patient with Charcot's joint, due to hereditary sensory neuropathy, that c aused loss of pain sensation. The bone and joint destruction in our patient 's left foot was stopped by bisphosphonate treatment, and signs of a recons tructive healing process were observed on the control radiographs, The trea tment was administered intravenously every 4 months for 2 years, without re striction on weightbearing, since the patient had refused a plaster cast an d an orthotic device. This observation suggests that treatment with bisphos phonates should be used before, or in combination with, other treatment in such cases.