Kurokawa Hiroaki, Taniguchi Akira, Ueno Yuki, Miyamoto Takuma, Tanaka Yasuhito
Nara Medical University, Kashihara, Nara, Japan.
Foot Ankle Orthop. 2023 Jun 11;8(2):24730114231178763. doi: 10.1177/24730114231178763. eCollection 2023 Apr.
With the increase in life expectancy, the prevalence of ankle osteoarthritis (OA) is also expected to increase in the future. Functional disability and diminished quality of life associated with end-stage ankle OA are comparable to those associated with end-stage hip or knee OA. However, there are few reports on the natural history and progression of patients with ankle OA. Hence, this study aimed to evaluate the risk factors for progression in patients with varus ankle OA.
We evaluated 68 ankles from 58 patients diagnosed with varus ankle OA using radiography performed at intervals over at least 60 months. The mean follow-up period was 99 ± 40 months. Narrowing of the joint space and increasing osteophyte formation were defined as ankle OA progression. Multivariate analysis was performed using logistic regression to predict the odds of progression; the model included 2 clinical variables and 7 radiographic variables.
Of the 68 ankles, 39 (57%) progressed. In multivariable logistic regression analyses, patient's age (odds ratio [OR] 0.92, 95% CI 0.85-0.99, < .03), and the talar tilt (TT; OR 2.2, 95% CI 1.39-3.42, = .001) were found to be independent factors for progression. The area under the curve (AUC) of the receiver operating characteristic curve for TT was 0.844, and the cutoff value was 2.0 degrees.
TT was found to be a primary factor associated with varus ankle OA progression. The risk appeared higher in patients with a TT more than 2.0 degrees.
Level III, retrospective case control study.
随着预期寿命的增加，踝关节骨关节炎（OA）的患病率预计在未来也会上升。与终末期踝关节OA相关的功能障碍和生活质量下降与终末期髋或膝关节OA相当。然而，关于踝关节OA患者的自然病史和病情进展的报道很少。因此，本研究旨在评估内翻型踝关节OA患者病情进展的危险因素。
我们对58例诊断为内翻型踝关节OA的患者的68个踝关节进行了评估，使用间隔至少60个月进行的X线摄影。平均随访期为99±40个月。关节间隙变窄和骨赘形成增加被定义为踝关节OA进展。使用逻辑回归进行多变量分析以预测进展的几率；该模型包括2个临床变量和7个放射学变量。
在68个踝关节中，39个（57%）出现了进展。在多变量逻辑回归分析中，患者年龄（比值比[OR]0.92，95%可信区间0.85-0.99，P<0.03）和距骨倾斜（TT；OR 2.2，95%可信区间1.39-3.42，P=0.001）被发现是进展的独立因素。TT的受试者工作特征曲线下面积（AUC）为0.844，截断值为2.0度。
TT被发现是与内翻型踝关节OA进展相关的主要因素。TT大于2.0度的患者风险似乎更高。
III级，回顾性病例对照研究。
