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Injury and local injection and the risk of foot/ankle osteoarthritis: a case–control study in retired UK male professional footballers

Title: Injury and local injection and the risk of foot/ankle osteoarthritis: a case–control study in retired UK male professional footballers
Authors: Thanoon, A.A.; Espahbodi, S.; Shuaib, M.A.; Millar, B.; Duncan, A.; Bowen, C.J.; O’Neill, T.W.; Wakefield, R.J.; Watt, F.E.; Walsh, D.A.; Fuller, G.; Batt, M.E.; Parekh, S.M.; Fernandes, G.S.; Doherty, M.; Zhang, W.
Publisher Information: Oxford University Press (OUP)
Publication Year: 2026
Collection: White Rose Research Online (Universities of Leeds, Sheffield & York)
Description: Objective The objective of this study was to examine whether foot/ankle injury and injection contribute to the risk of foot/ankle OA in retired UK male professional footballers. Methods This was a case–control study among retired UK male footballers, in which cases reported General Practitioner–diagnosed foot/ankle OA or forefoot/ankle surgery after retirement, and controls reported neither. Injury was defined as significant foot/ankle injury with pain for most days over 3 months during their career. Injection was defined as injection of corticosteroids or other agents into foot/ankle joints during their career. Adjusted odds ratios (aORs) with 95% confidence interval (CIs) were calculated using logistic regression. Areas Under the Curve (AUCs) and 95% CIs were estimated to examine the contribution of injury and/or injection in the context of other available risk factors. Results Of 424 footballers studied, 63 had foot/ankle OA and 361 had neither. Cases had similar mean age (63.2 vs 63.0, P = 0.457) and BMI (27.7 vs 27.0, P = 0.240) to those of controls, but more foot/ankle injury (73.3% vs 42.5%, P < 0.001) and injections (75.0% vs 48.4%, P < 0.001), with aORs of 4.23 (95% CI 1.88–9.48) and 2.62 (95% CI 1.19–5.78), respectively. The AUC was 0.69 (95% CI 0.62–0.77) for injury, 0.74 (95% CI 0.66–0.81) for injury and injection, and 0.78 (95% CI 0.70–0.85) for all risk factors. Similar results were observed in footballers with ankle OA only. Conclusion Injury was a major risk factor for foot/ankle OA in retired UK male professional footballers. The role of injection needs cautious interpretation due to potential confounding by indication.
Document Type: article in journal/newspaper
File Description: text
Language: English
ISSN: 1462-0324
Relation: https://eprints.whiterose.ac.uk/id/eprint/233742/1/keaf518.pdf; Thanoon, A.A. orcid.org/0000-0002-5998-4708 , Espahbodi, S., Shuaib, M.A. et al. (13 more authors) (2026) Injury and local injection and the risk of foot/ankle osteoarthritis: a case–control study in retired UK male professional footballers. Rheumatology, 65 (1). keaf518. ISSN: 1462-0324
Availability: https://eprints.whiterose.ac.uk/id/eprint/233742/; https://eprints.whiterose.ac.uk/id/eprint/233742/1/keaf518.pdf
Rights: cc_by_4
Accession Number: edsbas.78CE87D1
Database: BASE