Keele Research Repository

Downes, TJ, Chesterton, L, Whittle, R, Roddy, E, Menz, HB, Marshall, M and Thomas, MJ (2017) The symptomatic course of foot osteoarthritis phenotypes: an 18-month prospective analysis of community-dwelling older adults. Arthritis Care and Research.

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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.

Item Type:	Article
Additional Information:	This is the peer reviewed version of the following article: The symptomatic course of foot osteoarthritis phenotypes: an 18-month prospective analysis of community-dwelling older adults, which has been published in final form at 10.1002/acr.23502. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Subjects:	R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system
Divisions:	Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Related URLs:	Author
Depositing User:	Symplectic
Date Deposited:	09 Jan 2018 10:06
Last Modified:	29 Dec 2018 01:30
URI:	https://eprints.keele.ac.uk/id/eprint/4339

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