Population prevalence and distribution of ankle pain and symptomatic radiographic ankle osteoarthritis in community dwelling older adults: A systematic review and cross-sectional study

Objectives To 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. Methods Electronic 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. Results Eighteen 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. Conclusion No 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.

[1]  Jacqueline Raymond,et al.  Prevalence and impact of chronic musculoskeletal ankle disorders in the community. , 2012, Archives of physical medicine and rehabilitation.

[2]  G. Ejlertsson,et al.  Chronic pain in a geographically defined general population: studies of differences in age, gender, social class, and pain localization. , 1993, The Clinical journal of pain.

[3]  H. Karlsson.  The prevalence of what? , 2009, Nordic journal of psychiatry.

[4]  P. Croft,et al.  The prevalence of pain and pain interference in a general population of older adults: cross-sectional findings from the North Staffordshire Osteoarthritis Project (NorStOP) , 2004, Pain.

[5]  Daniel L Riddle,et al.  Body weight changes and corresponding changes in pain and function in persons with symptomatic knee osteoarthritis: A cohort study , 2013, Arthritis care & research.

[6]  R. Coleman,et al.  High prevalence of contralateral ankle abnormalities in association with knee osteoarthritis and malalignment. , 2013, Osteoarthritis and cartilage.

[7]  D. Pereira,et al.  The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review. , 2011, Osteoarthritis and cartilage.

[8]  N. Tejwani,et al.  Post-traumatic ankle arthritis. , 2013, Bulletin of the Hospital for Joint Disease.

[9]  R. Hirsch,et al.  Prevalence of knee osteoarthritis in the United States: arthritis data from the Third National Health and Nutrition Examination Survey 1991-94. , 2006, The Journal of rheumatology.

[10]  M. Boers,et al.  Differences in descriptions of Kellgren and Lawrence grades of knee osteoarthritis , 2008, Annals of the rheumatic diseases.

[11]  I. Adams,et al.  Osteoarthrosis and Sport , 1979, Journal of the Royal Society of Medicine.

[12]  H. Schmitt,et al.  Degenerative Changes in the Ankle in Former Elite High Jumpers , 2003, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[13]  Brian Caulfield,et al.  The Incidence and Prevalence of Ankle Sprain Injury: A Systematic Review and Meta-Analysis of Prospective Epidemiological Studies , 2013, Sports Medicine.

[14]  M. Bulsara,et al.  Hereditary hemochromatosis is characterized by a clinically definable arthropathy that correlates with iron load. , 2011, Arthritis and rheumatism.

[15]  G. Gold,et al.  Atlas of individual radiographic features in osteoarthritis, revised. , 2007, Osteoarthritis and cartilage.

[16]  R. Fillingim,et al.  Sex differences in pain: a brief review of clinical and experimental findings. , 2013, British journal of anaesthesia.

[17]  J. Ware,et al.  A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. , 1996, Medical care.

[18]  C. Teitz,et al.  Premature Osteoarthrosis in Professional Dancers , 1998, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[19]  G. Huston.  The Hospital Anxiety and Depression Scale. , 1987, The Journal of rheumatology.

[20]  Gheorghe Luta,et al.  Prevalence of knee symptoms and radiographic and symptomatic knee osteoarthritis in African Americans and Caucasians: the Johnston County Osteoarthritis Project. , 2007, The Journal of rheumatology.

[21]  B. Marti,et al.  Zur Arthrosegefährdung des oberen Sprunggelenkes bei Langstreckenläufern: Kontrollierte Nachuntersuchung ehemaliger Eliteathleten , 1990 .

[22]  A. Silman,et al.  The Cheshire Foot Pain and Disability Survey: a population survey assessing prevalence and associations , 2004, Pain.

[23]  T. Spector,et al.  Radiographic assessment of osteoarthritis in population studies: whither Kellgren and Lawrence? , 1993, Osteoarthritis and cartilage.

[24]  R. Panush,et al.  Is running associated with degenerative joint disease? , 1986, JAMA.

[25]  H. Menz,et al.  The clinical assessment study of the foot (CASF): study protocol for a prospective observational study of foot pain and foot osteoarthritis in the general population , 2011, Journal of foot and ankle research.

[26]  M. Hochberg,et al.  New radiographic grading scales for osteoarthritis of the hand. Reliability for determining prevalence and progression. , 1989, Arthritis and rheumatism.

[27]  R. Thomas,et al.  Ankle Arthritis , 2003, The Journal of bone and joint surgery. American volume.

[28]  S. Drawer,et al.  Propensity for osteoarthritis and lower limb joint pain in retired professional soccer players , 2001, British journal of sports medicine.

[29]  H. Menz,et al.  Radiographic classification of osteoarthritis in commonly affected joints of the foot. , 2007, Osteoarthritis and cartilage.

[30]  P. Vincelette,et al.  The footballer's ankle and foot. , 1972, Canadian Medical Association journal.

[31]  K. Kuettner,et al.  Prevalence of degenerative morphological changes in the joints of the lower extremity. , 1997, Osteoarthritis and cartilage.

[32]  J. Buckwalter,et al.  Epidemiology of ankle arthritis: report of a consecutive series of 639 patients from a tertiary orthopaedic center. , 2005, The Iowa orthopaedic journal.

[33]  J. Carrino,et al.  Atlas of radiographic features of osteoarthritis of the ankle and hindfoot. , 2015, Osteoarthritis and cartilage.

[34]  R. McCarney,et al.  Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care , 2001, Annals of the rheumatic diseases.

[35]  A. Brodelius.  Osteoarthrosis of the Talar Joints in Footballers and Ballet Dancers , 1961 .

[36]  P. Scranton,et al.  Anterior Tibiotalar Spurs: A Comparison of Open versus Arthroscopic Debridement , 1992, Foot & ankle.

[37]  M. Iosifidis,et al.  Lower limb clinical and radiographic osteoarthritis in former elite male athletes , 2015, Knee Surgery, Sports Traumatology, Arthroscopy.

[38]  E. Roddy,et al.  A rasch analysis of the Manchester foot pain and disability index , 2009, Journal of foot and ankle research.

[39]  B. Nilsson,et al.  Degenerative joint disease in ballet dancers. , 1989, Clinical orthopaedics and related research.

[40]  P. Tugwell,et al.  The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses , 2014 .

[41]  L. Jacobsson,et al.  Chronic musculoskeletal pain, prevalence rates, and sociodemographic associations in a Swedish population study. , 2001, The Journal of rheumatology.

[42]  G. Herrero-Beaumont,et al.  Osteoarthritis associated with estrogen deficiency , 2009, Arthritis research & therapy.

[43]  F. Guillemin,et al.  Prevalence of symptomatic hip and knee osteoarthritis: a two-phase population-based survey. , 2011, Osteoarthritis and cartilage.

[44]  Garry E Gold,et al.  Diagnosis of osteoarthritis: imaging. , 2012, Bone.

[45]  J B McKinlay,et al.  Prevalence of foot and ankle conditions in a multiethnic community sample of older adults. , 2004, American journal of epidemiology.

[46]  Shawn Garbedian,et al.  Systematic Review of the Prevalence of Radiographic Primary Hip Osteoarthritis , 2009, Clinical orthopaedics and related research.

[47]  M. Hochberg,et al.  Osteoarthritis I: epidemiology. , 1984, Maryland state medical journal.

[48]  H. Picavet,et al.  Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC3-study , 2003, Pain.

[49]  Guangju Zhai,et al.  A meta-analysis of sex differences prevalence, incidence and severity of osteoarthritis. , 2005, Osteoarthritis and cartilage.

[50]  R. Marti,et al.  Degenerative Joint Disease in Female Ballet Dancers , 1995, The American journal of sports medicine.

[51]  D. A. van der Windt,et al.  A systematic search and narrative review of radiographic definitions of hand osteoarthritis in population-based studies. , 2008, Osteoarthritis and cartilage.

[52]  B. Marti,et al.  Risk of Degenerative Ankle Joint Disease in Volleyball Players: Study of Former Elite Athletes , 1999, International journal of sports medicine.

[53]  W. Adebimpe,et al.  Pattern of arthralgia in an urban community in Southwestern Nigeria. , 2014, Annals of African medicine.

[54]  M. Marshall,et al.  A systematic review of radiographic definitions of foot osteoarthritis in population-based studies. , 2010, Osteoarthritis and cartilage.

[55]  Bill Vicenzino,et al.  Prevalence of hallux valgus in the general population: a systematic review and meta-analysis , 2010, Journal of foot and ankle research.

[56]  A. Woolf,et al.  Burden of major musculoskeletal conditions. , 2003, Bulletin of the World Health Organization.

[57]  A. Silman,et al.  Development and validation of a questionnaire to assess disabling foot pain , 2000, Pain.

[58]  C. Helmick,et al.  Prevalence of Hip Symptoms and Radiographic and Symptomatic Hip Osteoarthritis in African Americans and Caucasians: The Johnston County Osteoarthritis Project , 2009, The Journal of Rheumatology.

[59]  H. Menz,et al.  The population prevalence of symptomatic radiographic foot osteoarthritis in community-dwelling older adults: cross-sectional findings from the Clinical Assessment Study of the Foot , 2013, Annals of the rheumatic diseases.

[60]  H. Menz,et al.  The population prevalence of foot and ankle pain in middle and old age: A systematic review , 2011, PAIN.

[61]  V Wright,et al.  The knees and ankles in sport and veteran military parachutists. , 1977, Annals of the rheumatic diseases.

[62]  A. Svanborg,et al.  Osteoarthritis in the elderly: clinical and radiological findings in 79 and 85 year olds. , 1991, Annals of the rheumatic diseases.

[63]  P. Baltopoulos,et al.  Osteoarthritis of the Ankle and Foot Complex in Former Greek Soccer Players , 2011, Foot & ankle specialist.

[64]  D. M. van der Heijde,et al.  Radiographic scoring methods in hand osteoarthritis--a systematic literature search and descriptive review. , 2014, Osteoarthritis and cartilage.

[65]  Lena Osterhagen,et al.  Multiple Imputation For Nonresponse In Surveys , 2016 .

[66]  B. Koes,et al.  Validity and reliability of three definitions of hip osteoarthritis: cross sectional and longitudinal approach , 2004, Annals of the rheumatic diseases.

[67]  F. Wilder,et al.  Joint-specific prevalence of osteoarthritis of the hand. , 2006, Osteoarthritis and cartilage.

[68]  M. Takao.  Musculoskeletal , 2020, Journal of Japan Society of Computer Aided Surgery.

[69]  L. Sondergaard,et al.  Long distance running and osteoarthrosis , 1990, The American journal of sports medicine.

[70]  Bernadette A. Thomas,et al.  Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010 , 2012, The Lancet.

[71]  P. Dieppe,et al.  Prevalence and risk factors for joint pain among men and women in the West of Scotland Twenty-07 study , 2005, Annals of the rheumatic diseases.

[72]  D. A. van der Windt,et al.  Subsets of symptomatic hand osteoarthritis in community-dwelling older adults in the United Kingdom: prevalence, inter-relationships, risk factor profiles and clinical characteristics at baseline and 3-years , 2013, Osteoarthritis and cartilage.