Foot/Ankle Injury and Corticosteroid Use Linked to Osteoarthritis in Former Soccer Players: Study

A new study published in the journal of Rheumatology showed that injury history is a significant risk factor for developing osteoarthritis (OA) of the foot or ankle, as stated by former soccer players who have OA of these joints.

Ankle sprains and metatarsal fractures, in particular, are common in professional football and can result in osteoarthritis and chronic discomfort. Injection treatments may allow for a quick return to play, but their broad usage is still debatable because of the scant data and worries about speeding joint degeneration and concealing injuries. Thus, this study investigated if injections and foot/ankle injuries increase the incidence of foot/ankle OA in male professional football players who had retired from the UK.

In this case-control research of retired male football players from the UK, the cases reported either forefoot/ankle surgery or foot/ankle OA diagnosed by a general practitioner after retirement, whereas the controls reported neither. A major foot or ankle injury that caused discomfort on most days for more than three months during their career was considered an injury. During their career, injection was defined as injecting corticosteroids or other medicines into the ankle or foot joints. 

63 of the 424 football players in the study had foot/ankle OA, whereas 361 did not. The mean age (63.2 vs. 63.0, P = 0.457) and BMI (27.7 vs. 27.0, P = 0.240) of the cases were similar to those of the controls, but there were more foot/ankle injuries (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 1.88–5.78), respectively). The AUC for injury was 0.69 (95% CI 0.62–0.77), for injury and injection it was 0.74 (95% CI 0.66–0.81), and for all risk factors it was 0.78 (95% CI 0.70–0.85). 

Football players with ankle OA alone had similar outcomes. Overall, among retired male professional football players in the UK, foot/ankle injuries sustained during their career were a significant risk factor for later foot/ankle OA. Confounding by indication could not be ruled out, despite the fact that injection was also linked to foot/ankle OA. 

Source:

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. (2025). Injury and local injection and the risk of foot/ankle osteoarthritis: a case-control study in retired UK male professional footballers. Rheumatology (Oxford, England), keaf518. https://doi.org/10.1093/rheumatology/keaf518