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A new study published in Osteoarthritis and Cartilage Open could help improve the lives of people at risk of developing knee osteoarthritis.

A doctor treats a patient with knee osteoarthritis © Shutterstock

A new study has identified a link between ankle pain and the onset of symptoms of knee osteoarthritis (OA).

"Foot and ankle symptoms are very common among middle-aged and older adults, and isolated joint pain in OA is uncommon," said Dr Thomas Perry, lead author of the study and postdoctoral researcher in molecular pathogenesis of osteoarthritis pain at NDORMS. "Although it has been established that symptoms and/or structural OA in lower extremity joints (e.g., ankle) can affect other kinematically involved joints such as the knee, there is little data describing the relationship between the ankle/foot and incident knee OA outcomes."

Using data from the Multicentre Osteoarthritis Study (MOST), the researchers examined the relationship between three symptoms; ankle pain, foot pain, and ankle and foot pain, and different knee outcomes.

"In our study, ankle pain, and ankle with foot pain were associated with an increased risk of developing symptomatic radiographic knee OA and frequent knee pain, respectively. No associations were observed between foot pain only and knee OA outcomes. These data suggest that ankle pain may be a key risk factor for the development of knee OA. This knowledge could help design treatments to preserve the function of the ankle as a preventative measure to future knee pain," said Thomas.

Professor Neil Segal, University of Kansas, said: "Knee pain and particularly painful knee osteoarthritis is one of the most disabling problems for older adults. While we do not understand all the reasons that people develop these problems, biomechanical factors certainly play a role. Since there is no cure, reducing risk for developing the disease is key. The foot and ankle is 'where the rubber hits the road' so-to-speak, so this study offered useful new understandings as the first study to assess relationships between ankle pain and risk for knee problems. While there is more work to do to determine the mechanism for how ankle and foot pain increase the odds of developing painful knee osteoarthritis, this study was important in opening the door to those discoveries to improve patient care."

Professor Cathy Bowen, University of Southampton, added: "Foot and ankle pain is a common occurrence for many and is often associated with knee pain, yet it remains severely under-studied and under-appreciated for possible interventions. In this investigation we have contributed evidence that will help researchers better understand mechanisms of knee pain by focussing more closely on the interaction of the ankle with the knee which we hope in turn will help guide clinicians towards developing tailored interventions aimed at reducing/preventing ankle pain as well as managing knee pain."

The study was a collaboration between the University of Oxford and University of Southampton in the UK and the University of Kansas Medical Centre, The University of Iowa, and University of California San Francisco.

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