Perry Thomas A, Segal Neil A, Bowen Catherine, Gates Lucy, Arden Nigel, Nevitt Michael C
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Old Road, Oxford, OX3 7LD, United Kingdom.
Centre for Sport, Exercise and Osteoarthritis Versus Arthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom.
Osteoarthr Cartil Open. 2021 Dec;3(4):100210. doi: 10.1016/j.ocarto.2021.100210.
To examine whether foot and/or ankle pain increases the risk of knee OA.
We utilised longitudinal data from the Multicentre Osteoarthritis Study (MOST); a community-based cohort of risk factors for knee OA. Participants without frequent knee pain (clinic visit only) and radiographic knee OA (RKOA) at baseline and, with no evidence of inflammatory musculoskeletal disease and a history of knee-related surgery were followed for up to 84-months for incident outcomes; i) RKOA (Kellgren-Lawrence (KL) ≥2), ii) symptomatic RKOA (RKOA and frequent pain in the same knee) and iii) frequent knee pain only. At baseline, ankle and foot symptoms were assessed, with knee radiographs and symptoms also assessed at 30, 60 and 84-months. Our exposures included baseline ankle, foot, and ankle and foot pain (participant-level). Associations between foot and/or ankle pain and incident outcomes were assessed using multiple logistic regression, with adjustment for participant characteristics and ankle/foot pain.
No statistically significant associations were observed between ankle, foot and, ankle and foot pain and incident RKOA, respectively. Ankle pain with (2.30, 95% CI 1.13 to 4.66) and without foot pain (OR: 2.53, 95% CI 1.34 to 4.80) were associated with increased odds of incident symptomatic RKOA and frequent knee pain. No statistically significant associations were observed between foot pain and these outcomes.
Ankle pain should be a focus point, more so than foot pain, in the management of knee OA. Future studies should include additional ankle joint-specific symptom questions to better elucidate the knee OA biomechanical pathway.
探讨足和/或踝关节疼痛是否会增加患膝关节骨关节炎（OA）的风险。
我们利用了多中心骨关节炎研究（MOST）的纵向数据；这是一个基于社区的膝关节OA危险因素队列。对基线时无频繁膝关节疼痛（仅门诊就诊）和影像学膝关节OA（RKOA）、无炎症性肌肉骨骼疾病证据且无膝关节相关手术史的参与者进行长达84个月的随访，观察以下事件结局：i）RKOA（凯尔格伦-劳伦斯（KL）分级≥2级），ii）有症状的RKOA（RKOA且同一膝关节频繁疼痛），以及iii）仅频繁膝关节疼痛。在基线时评估踝关节和足部症状，在30、60和84个月时也评估膝关节X线片和症状。我们的暴露因素包括基线时的踝关节、足部以及踝关节和足部疼痛（个体水平）。采用多元逻辑回归评估足和/或踝关节疼痛与事件结局之间的关联，并对参与者特征和踝关节/足部疼痛进行调整。
分别未观察到踝关节、足部以及踝关节和足部疼痛与新发RKOA之间存在统计学显著关联。伴有足部疼痛（比值比（OR）：2.30，95%置信区间（CI）1.13至4.66）和不伴有足部疼痛（OR：2.53，95%CI 1.34至4.80）的踝关节疼痛与新发有症状RKOA和频繁膝关节疼痛的几率增加相关。未观察到足部疼痛与这些结局之间存在统计学显著关联。
在膝关节OA的管理中，踝关节疼痛应比足部疼痛更受关注。未来的研究应纳入更多踝关节特异性症状问题，以更好地阐明膝关节OA的生物力学途径。
