The symptomatic course of foot osteoarthritis phenotypes: an 18-month prospective analysis of community-dwelling older adults.

Downes, Thomas J.; Chesterton, Linda; Whittle, Rebecca; Roddy, Ed; Menz, Hylton B.; Marshall, Michelle; Thomas, Martin J.

Abstract

OBJECTIVE: Osteoarthritis (OA) is a heterogeneous disease with symptom progression at the foot unclear. This study investigated the symptomatic course of three pre-defined foot OA phenotypes over an 18-month period. METHODS: The Clinical Assessment Study of the Foot (CASF) is a community-based cohort of adults aged =50 years in North Staffordshire, UK. Participants who reported foot pain in a postal health survey and underwent radiographic assessment were mailed an 18-month follow-up survey. Changes in descriptive and symptomatic outcomes over 18 months were compared across the three phenotypes to determine within-phenotype changes and between-phenotype differences. RESULTS: Of 533 participants at baseline, 478 (89.7%) responded at 18 months. All three phenotypes showed small within-phenotype improvements in mean foot pain severity (scale from 0=no pain to 10=worst pain): no or minimal foot OA (18-month 4.0; mean change -1.15 [95% CI -1.46,-0.83]), isolated first metatarsophalangeal joint (MTPJ) OA (18-month 4.1; mean change -0.60 [95% CI -1.11,-0.10]) and polyarticular foot OA (18-month 5.1; mean change -0.77 [95% CI -1.42,-0.12]). The isolated first MTPJ OA phenotype had an increased likelihood of hallux valgus in the left foot (adjusted odds ratio 2.96 [95% CI 1.23,7.12]) compared to the no or minimal foot OA phenotype. CONCLUSION: Three foot OA phenotypes showed few descriptive or symptomatic changes over 18 months. Future clinical trials should consider that people recruited with mild-to-moderate symptomatic foot OA appear likely to remain relatively stable with usual care. Longer-term follow-up using additional time-points is required to describe further the natural history of foot OA. This article is protected by copyright. All rights reserved.

Citation

Downes, T. J., Chesterton, L., Whittle, R., Roddy, E., Menz, H. B., Marshall, M., & Thomas, M. J. (2018). The symptomatic course of foot osteoarthritis phenotypes: an 18-month prospective analysis of community-dwelling older adults. Arthritis Care and Research, 70(7), 1107-1112. https://doi.org/10.1002/acr.23502

• Journal Article Type: Article
• Acceptance Date: Dec 19, 2017
• Online Publication Date: Dec 29, 2017
• Publication Date: 2018-07
• Journal: Arthritis Care and Research
• Print ISSN: 2151-464X
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 70
• Issue: 7
• Pages: 1107-1112
• DOI: https://doi.org/10.1002/acr.23502
• Publisher URL: http://onlinelibrary.wiley.com/doi/10.1002/acr.23502/abstract;jsessionid=0090AFFD05F14559FF160B0DA6995F57.f01t03