Reachout Orthopedics - Issue 2

Kade L. Paterson 1 , Lucy Gates 2 Kade L. Paterson kade.paterson@unimelb.edu.au 1  Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, School of Health Sciences, The University of Melbourne, Parkville, VIC 3010, Australia 2  Arthritis Research UK Centre for Sport Exercise and Osteoarthritis, University of Southampton, Southampton, UK Practice Guide CLINICAL ASSESSMENT AND MANAGEMENT OF FOOT AND ANKLE OSTEOARTHRITIS: A REVIEW OF CURRENT EVIDENCE AND FOCUS ON PHARMACOLOGICAL TREATMENT y y Foot osteoarthritis (OA) is very common, particularly in older adults, and there is a growing body of evidence that it is highly disabling. y y There is little research on management strategies for foot and ankle OA; however, it is possible that pharmacological approaches recommended for knee and hip OA are effective, including acetaminophen (paracetamol) and/or topical non-steroidal anti-inflammatory drugs (NSAIDs) or capsaicin. y y Oral NSAIDs (including a cyclo-oxygenase-2 inhibitor) or intra-articular hyaluronic acid injections may be considered if initial pharmacological approaches are ineffective, especially for ankle OA, but further high- quality clinical trials are necessary. Key Points O steoarthritis (OA) is a major global public health problem, with a worldwide prevalence of 23.9% [1]. The condition causes significant pain and disability, and adversely affects quality of life. Disability associated with OA also results in a substantial economic burden. This economic burden is due to direct treatment-related costs, particularly joint replacement surgery, in addition to indirect costs such as lost productivity [2, 3]. Rates of OA are projected to rapidly increase over the coming decades as the population ages and rates of obesity rise [4]. As a consequence, it is anticipated that there will be a large increase in demand for health services for the symptoms and disability associated with OA in the coming years. 18 Foot and ankle osteoarthritis (OA) is a common and disabling problem that adversely affects physical function and significantly reduces quality of life. Although the knee was considered to be the lower-limb site most often affected by OA, recent population data showed foot OA is as prevalent as knee OA, and rates increase with advancing years.