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Population Prevalence and Distribution of Ankle Pain and Symptomatic Radiographic Ankle Osteoarthritis in Community Dwelling Older Adults: A Systematic Review and Cross-Sectional Study

Murray, Charlotte; Marshall, Michelle; Rathod, Trishna; Bowen, Catherine J.; Menz, Hylton B.; Roddy, Edward

Population Prevalence and Distribution of Ankle Pain and Symptomatic Radiographic Ankle Osteoarthritis in Community Dwelling Older Adults: A Systematic Review and Cross-Sectional Study Thumbnail


Authors

Charlotte Murray

Trishna Rathod

Catherine J. Bowen

Hylton B. Menz



Abstract

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.

Citation

Murray, C., Marshall, M., Rathod, T., Bowen, C. J., Menz, H. B., & Roddy, E. (2018). Population Prevalence and Distribution of Ankle Pain and Symptomatic Radiographic Ankle Osteoarthritis in Community Dwelling Older Adults: A Systematic Review and Cross-Sectional Study. PloS one, 13(4), Article e0193662. https://doi.org/10.1371/journal.pone.0193662

Journal Article Type Article
Acceptance Date Apr 17, 2018
Online Publication Date Apr 30, 2018
Publication Date Apr 30, 2018
Journal PloS one
Print ISSN 1932-6203
Publisher Public Library of Science
Peer Reviewed Peer Reviewed
Volume 13
Issue 4
Article Number e0193662
DOI https://doi.org/10.1371/journal.pone.0193662
Publisher URL https://doi.org/10.1371/journal.pone.0193662

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