Knee Joint Hypermobility May Be Linked to OA Foot, Ankle Symptoms

doctor looking at x-rays
doctor looking at x-rays
Researchers examine the relationship of joint hypermobility with osteoarthritis and symptoms at the foot or ankle.

Knee joint hypermobility may be associated with symptoms of ankle and foot osteoarthritis (OA), as well as with talonavicular OA, according to results of a cross-sectional cohort study published in Arthritis Care & Research.

The investigators sought to explore the relationship between joint hypermobility and symptoms of ankle and foot OA, along with radiographic evidence of disease, in a cohort of African American and Caucasian patients between 55 and 94 years from the Johnston County Osteoarthritis Project. Ankle and foot radiographs, along with joint hypermobility data, were available for 848 participants between 2003 and 2010. General joint hypermobility was defined as a Beighton Criteria score ≥4, and knee hypermobility was defined as hyperextension of at least 1 knee.

Standing anteroposterior and lateral foot radiographs were performed from 2013 to 2015 to identify OA at 5 foot joints. Ankle and foot symptoms were self-reported. Logistic regression models were used to assess associations of ankle and foot OA and symptom outcomes with hypermobility measures, adjusting for age, sex, race, body mass index (BMI), and history of ankle or foot injury.

The study cohort included 68% women and 33% African American participants. The mean patient age was 71 years, and the mean BMI was 31 kg/m2. General joint hypermobility was present in 7% of participants, and knee hypermobility was present in 4%. Ankle injuries were reported among 11.5% of participants, and foot injuries among 3.8%.

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General joint hypermobility was not associated with ankle and foot outcomes. Knee hypermobility, in contrast, was linked to ankle symptoms (adjusted odds ratio [aOR], 4.41; 95% CI, 2.06-9.44), foot symptoms (aOR, 2.40; 95% CI, 1.15-5.04), and talonavicular OA (aOR, 3.05; 95% CI, 1.10-8.51).

The investigators concluded that the results of this study should be further examined in other populations of patients and in longitudinal analyses, particularly in studies that may include data on joint hypermobility at a younger age to determine the contribution of joint hypermobility over time to the incidence and the progression of ankle and foot OA outcomes.

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Golightly YM, Hannan MT, Nelson AE, et al. Relationship of joint hypermobility with ankle and foot radiographic osteoarthritis and symptoms in a community-based cohort [published June 28, 2018]. Arthritis Care Res (Hoboken). doi: 10.1002/acr.23686