646 Bangladesh Journal of Medical Science Vol. 20 No. 03 July’21 Case report: Outcome of treatment of Eichenholtz stage III charcot neuroarthropathy by using bilayer insole: a single center study Ng Bing Wui 1 , Ohnmar Htwe 2 , Amaramalar Selvi Naicker 3 , Brenda Saria Yuliawiratman 4 , Mohd Yazid Bajuri 5 , Manimalar Selvi Naicker 6 , Nurwahidah Abdul Rouf 7 Abstract Introduction: Insoles are recommended for the treatment of patients with neuropathic foot to distribute the foot plantar pressure while preventing recurrent ulceration. Diferent types of insole are available but the cost is the major limiting factor. Thus, it is justifable to conduct this study to evaluate the efcacy of cost efective locally-designed bilayer Lunairmed insoles as an adjunctive treatment for patients with Eichenholtz Stage III Charcot neuroarthropathy in our centre. Methods: This was a prospective observational study conducted in tertiary centre, Malaysia from September 2016 to September 2017. A total of ten patients with Stage III Charcot neuroarthropathic foot without ankle instability were included. All patients were evaluated for foot plantar pressure by using Tekscan, short form (SF-36) and American Orthopaedic Foot and Ankle Society(AOFAS) score before and after using insoles. Results: Fifteen out of twenty feet showed reduction in peak plantar pressure (PP) and force-time-integral (FTI) at forefoot and heel after using bilayer Lunairmed insoles. There was a mean reduction of 24.8% of total foot PP. Conclusion: Locally designed bilayer Lunairmed insoles could be used to reduce PP in Eichenholtz Stage III Charcot neuroarthropathic foot without ankle instability. Keywords: Eichenholtz Stage III; Charcot foot; bilayer Lunairmed insoles; SF-36; AOFAS score Correspondence to: Dr. Ng Bing Wui, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Batu 9 Cheras, Wilayah Persekutuan Kuala Lumpur . Email: bingwuing@gmail.com 1. Ng Bing Wui, Department of Orthopaedics and Traumatology, Faculty of Medicine, University Kebangsaan Malaysia. 2. Ohnmar Htwe 3. Amaramalar Selvi Naicker 4. Brenda Saria Yuliawiratman Rehabilitation Medicine Unit, Department of Orthopaedics and Traumatology, Faculty of Medicine, University Kebangsaan Malaysia. 5. Mohd Yazid Bajuri, Department of Orthopaedics and Traumatology, Faculty of Medicine, University Kebangsaan Malaysia. 6. Manimalar Selvi Naicker, Department of Pathology, Faculty of Medicine, University Malaya. 7. Nurwahidah Abdul Rouf, Prosthetic and Orthotic Unit, Department of Medical Rehabilitation Services, Hospital Canselor Tuanku Muhriz Universiti Kebangsha, Malaysia. Bangladesh Journal of Medical Science Vol. 20 No. 03 July’21. Page : 646-650 DOI: https://doi.org/10.3329/bjms.v20i3.52809 Introduction Charcot neuroarthropathy of the foot is characterized by sensory and peripheral autonomic neuropathy which leads to generalized swelling, instability and deformity of the foot. The goals of treatment for Charcot neuroarthropathy are to achieve a plantigrade, stable, shoeable foot and to prevent recurrent ulceration. 1,2,3 The recommended treatments for plantigrade and stable Stage III Charcot foot consist of usage of diferent types of insoles to prevent recurrent ulceration. Few authors had published the outcome of non-operative management of Charcot neuroarthropathy using custom made insoles in their centres with success rate of up to 59% in preventing recurrent ulcers. 4,5 Characteristics of various materials had been studied butclinical signifcance of usage of such material in clinical practise is yet to be determined. Furthermore, no data has been published regarding the treatment outcome of patients with Stage III Charcot neuroarthropathy using locally