Prevalence of foot/ankle osteoarthritis and pain in retired male professional footballers compared to general population male controls: a cross-sectional study

Objectives

To examine whether retired male professional footballers have a higher risk of foot/ankle osteoarthritis (OA) and pain than general population male controls.

Methods

In this cross-sectional study, questionnaires for self-reported foot/ankle OA outcomes were posted to 878 footballers and 1060 controls, and subsequently a sample of responders per group underwent assessment for radiographic OA (ROA) irrespective of symptoms. ROA was defined using the La Trobe atlas when definite osteophyte (score ≥ 2) or definite joint space narrowing (score ≥ 2) was observed at any assessed foot/ankle joint. Symptomatic ROA (sROA) was defined as presence of ROA and pain in the same region of the foot for most days of the past month. Adjusted relative risks (aRRs) with 95% confidence intervals (CI) were calculated using robust Poisson regression.

Results

. 468 footballers (53%) and 619 controls (58%) completed questionnaires, of whom 113 footballers and 319 controls underwent radiographic assessment. Compared with controls, footballers were more likely to: (1) report General Practitioner diagnosed foot/ankle OA (aRR 1.77, 95% CI 1.22–2.57), forefoot/ankle surgery (aRR 2.80, 95% CI 2.04–3.84), and current foot/ankle pain (aRR 1.33, 95% CI 1.09–1.62); and (2) have foot/ankle ROA (aRR 1.04, 95% CI 1.01–1.07) and sROA (aRR 1.63, 95% CI 1.21–2.19).

Conclusion

Retired male professional footballers were more likely to have self-reported and radiographic foot/ankle OA than general population male controls. The ankle appeared the joint most affected by OA in footballers compared with controls. Further study is needed in female footballers and to determine specific risk factors related to this increased risk.