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Midfoot osteoarthritis: potential phenotypes and their associations with demographic, symptomatic and clinical characteristics

Arnold, J. B.; Marshall, M.; Thomas, M. J.; Redmond, A. C.; Menz, H. B.; Roddy, E.

Midfoot osteoarthritis: potential phenotypes and their associations with demographic, symptomatic and clinical characteristics Thumbnail


Authors

J. B. Arnold

A. C. Redmond

H. B. Menz



Abstract

Objective
To investigate the demographic, symptomatic, clinical and structural foot characteristics associated with potential phenotypes of midfoot osteoarthritis (OA).

Design
Cross-sectional study of 533 community-dwelling adults aged =50 years with foot pain in the past year. Health questionnaires and clinical assessments of symptoms, foot structure and function were undertaken. Potential midfoot OA phenotypes were defined by the pattern of radiographic joint involvement affecting either the medial midfoot (talonavicular, navicular-1st cuneiform, or cuneiform-1st metatarsal joint), central midfoot (2nd cuneiform-metatarsal joint), or both medial and central midfoot joints. Multivariable regression models with generalised estimating equations were used to investigate the associations between patterns of midfoot joint involvement and symptomatic, clinical and structural characteristics compared to those with no or minimal midfoot OA.

Results
Of 879 eligible feet, 168 had medial midfoot OA, 103 central midfoot OA, 76 both medial and central midfoot OA and 532 no/minimal OA. Having both medial and central midfoot OA was associated with higher pain scores, dorsally-located midfoot pain (OR 2.54, 95%CI 1.45, 4.45), hallux valgus (OR 1.76, 95%CI 1.02, 3.05), flatter foot posture (ß 0.44, 95%CI 0.12, 0.77), lower medial arch height (ß 0.02, 95%CI 0.01, 0.03) and less subtalar inversion and 1st MTPJ dorsiflexion. Isolated medial midfoot OA and central midfoot OA had few distinguishing clinical characteristics.

Conclusions
Distinct phenotypes of midfoot OA appear challenging to identify, with substantial overlap in symptoms and clinical characteristics. Phenotypic differences in symptoms, foot posture and function were apparent in this study only when both the medial and central midfoot were involved.

Citation

Arnold, J. B., Marshall, M., Thomas, M. J., Redmond, A. C., Menz, H. B., & Roddy, E. (2019). Midfoot osteoarthritis: potential phenotypes and their associations with demographic, symptomatic and clinical characteristics. Osteoarthritis and Cartilage, 27(4), 659-666. https://doi.org/10.1016/j.joca.2018.12.022

Journal Article Type Article
Acceptance Date Dec 23, 2018
Online Publication Date Jan 17, 2019
Publication Date 2019-04
Publicly Available Date May 26, 2023
Journal OSTEOARTHRITIS AND CARTILAGE
Print ISSN 1063-4584
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 27
Issue 4
Pages 659-666
DOI https://doi.org/10.1016/j.joca.2018.12.022
Keywords foot, osteoarthritis, phenotype, midfoot, pain, function
Publisher URL https://www.journals.elsevier.com/osteoarthritis-and-cartilage/