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Usually, the Charcot joint caused by neurosyphilis is regarded as a contraindication for total knee arthroplasty (TKA), and there are case reports in abroad but not in China. However, there are many complications after replacement.To review the therapy progress of Charcot joints caused by substantial neurosyphilis.More than 30 scientific civil and foreign literatures were reviewed scientifically to summarize the diagnosis and treatment scheme of neurosyphilis, as well as the surgical therapy of the Charcot joints caused by tabes dorsalis.Serum and cerebrospinal fluid check combined with typical clinical symptoms and signs could be diagnosed as the tabes dorsalis definitely. Penicillin is the first-line pharmaceutical apply for tabes dorsalis. Late-stage Charcot joints lesions may be treated with the TKA. Hinged TKA can cure the Charcot joints and improve the function of knee joints obviously.