Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA.
Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA; Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA; Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC, USA.
Semin Arthritis Rheum. 2021 Feb;51(1):230-235. doi: 10.1016/j.semarthrit.2020.10.015. Epub 2020 Dec 21.
To determine the incidence and progression of ankle osteoarthritis (OA) and associated risk factors in a community-based cohort of African Americans and whites.
Data were from 541 participants who had standardized lateral and mortise radiography of the ankles in weight bearing at baseline (2013-2015) and follow-up (2017-2018). Incident radiographic ankle OA (rAOA) was defined as a Kellgren-Lawrence grade (KLG) ≥ 1 at follow-up among ankles with baseline KLG < 1; progressive rAOA was a ≥ 1 KLG increase at follow-up among ankles with KLG ≥ 1 at baseline. Symptoms were assessed using self-reported pain, aching, and stiffness (PAS) on most days and the Foot and Ankle Outcome Score (FAOS) symptoms subscale. Ankle-level logistic regression models were used to assess associations of ankle outcomes with covariates (age, sex, race, body mass index [BMI], smoking, number of symptomatic joints, comorbidities, prior ankle injury, and knee or foot OA).
Among ankles without rAOA at baseline, 28% developed incident rAOA, 37% had worsening FAOS symptoms, and 7% had worsening PAS. Incident rAOA and worsening ankle symptoms were associated with higher BMI and symptoms in other joints. Among ankles with baseline rAOA, 4% had progressive rAOA, 35% had worsening of FAOS symptoms, and 9% had worsening PAS. rAOA progression was associated with ankle injury and concomitant knee or foot OA; worsening of symptoms was associated with higher BMI and other symptomatic joints.
Not all ankle OA is post-traumatic. Smoking prevention/cessation, a healthy weight, and injury prevention may be methods for reducing the incidence and progression of rAOA.
在一个基于社区的非裔美国人和白人队列中，确定踝关节骨关节炎（OA）的发生率和进展及其相关危险因素。
数据来自 541 名参与者，他们在基线（2013-2015 年）和随访（2017-2018 年）时进行了标准化的外侧和跗骨负重踝关节放射摄影。新发放射学踝关节 OA（rAOA）定义为基线时 KLG<1 的踝关节在随访时出现 KLG≥1；在基线时 KLG≥1 的踝关节在随访时出现 KLG 增加≥1 级为进展性 rAOA。使用自我报告的疼痛、酸痛和僵硬（PAS）在大多数日子和足踝结果评分（FAOS）症状子量表评估踝关节症状。使用踝关节水平逻辑回归模型评估踝关节结局与协变量（年龄、性别、种族、体重指数[BMI]、吸烟、症状关节数、合并症、既往踝关节损伤以及膝或足部 OA）的关联。
在基线时没有 rAOA 的踝关节中，28%发生新发 rAOA，37% FAOS 症状恶化，7% PAS 恶化。新发 rAOA 和踝关节症状恶化与较高的 BMI 和其他关节的症状有关。在基线时患有 rAOA 的踝关节中，4%发生进展性 rAOA，35% FAOS 症状恶化，9% PAS 恶化。rAOA 进展与踝关节损伤和同时存在的膝或足部 OA 有关；症状恶化与较高的 BMI 和其他有症状的关节有关。
并非所有踝关节 OA 都是创伤后性的。预防/戒烟、健康体重和预防损伤可能是减少 rAOA 发生率和进展的方法。
