Six-month treatment with alendronate in acute Charcot neuroarthropathy: a randomized controlled trial.

Charcot neuroarthropathy is defined by painful or relatively painless bone and joint deformity in limbs that have lost sensory innervation (1). The incidence is 0.1–5% in diabetic patients with peripheral neuropathy (2,3). The pathogenesis of Charcot neuroarthropathy is unknown (1,4). In acute Charcot neuroarthropathy, osteoclast activity increases (5). Alendronate is a bisphosphonate that induces the apoptosis of the osteoclasts (6). The utilization of the alendronate could improve the clinical signs of acute Charcot neuroarthropathy and stop bone reabsorption.