Abstract

ObjectivesTo identify by systematic review published prevalence estimates of radiographic ankle osteoarthritis (OA) and to subsequently estimate the prevalence of ankle pain and symptomatic, radiographic ankle OA within community-dwelling older adults from North Staffordshire, UK.MethodsElectronic databases were searched using terms for ankle, osteoarthritis and radiography. Data regarding population, radiographic methods, definitions and prevalence estimates of ankle OA were extracted from papers meeting predetermined selection criteria. Adults aged ≥50 years and registered with four general practices in North Staffordshire were mailed a health questionnaire. Ankle pain in the previous month was determined using a foot and ankle pain manikin. Respondents reporting pain in or around the foot in the last 12 months were invited to attend a research clinic where weight-bearing, antero-posterior and lateral ankle radiographs were obtained and scored for OA using a standardised atlas. Prevalence estimates for ankle pain and symptomatic, radiographic ankle OA were calculated using multiple imputation and weighted logistic regression, and stratified by age, gender and socioeconomic status.ResultsEighteen studies were included in the systematic review. The methods of radiographic classification of ankle OA were poorly reported and showed heterogeneity. No true general population prevalence estimates of radiographic ankle OA were found, estimates in select sporting and medical community-dwelling populations ranged from 0.0–97.1%. 5109 participants responded to the health survey questionnaire (adjusted response 56%). Radiographs were obtained in 557 participants. The prevalence of ankle pain was 11.7% (10.8,12.6) and symptomatic, radiographic ankle OA grade≥2 was 3.4% (2.3, 4.5) (grade≥1: 8.8% (7.9,9.8); grade = 3: 1.9% (1.0,2.7). Prevalence was higher in females, younger adults (50–64 years) and those with routine/manual occupations.ConclusionNo general population prevalence estimates of radiographic ankle OA were identified in the published literature. Our prevalence study found that ankle pain was common in community-dwelling older adults, whereas moderate to severe symptomatic, radiographic ankle OA occurred less frequently. Further investigations of the prevalence of ankle OA using more sensitive imaging modalities are warranted.

Highlights

  • Osteoarthritis (OA) is a recognised global burden of disease, affecting more than 100 million people worldwide [1]

  • No true general population prevalence estimates of radiographic ankle OA were found, estimates in select sporting and medical community-dwelling populations ranged from 0.0–97.1%. 5109 participants responded to the health survey questionnaire

  • No general population prevalence estimates of radiographic ankle OA were identified in the published literature

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Summary

Introduction

Osteoarthritis (OA) is a recognised global burden of disease, affecting more than 100 million people worldwide [1]. Estimates of the prevalence of ankle pain range from 9% to 15% in general adult populations [4,5]. Previous reviews have examined the methods of radiographic assessment at the knee, hip, hand and foot [6, 7, 8, 9]. The methods used to examine radiographic ankle OA and define its presence have not been reviewed previously, and estimates of ankle OA have ranged widely between 0 and 97% [10,11]. The variations between studies regarding the methods and definitions used for radiographic ankle OA, as well as the characteristics of the study populations examined, may explain the differences in reported prevalence estimates between studies

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