Global, regional, and national burden of osteoarthritis, 1990–2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021

Jaimie D Steinmetz(University of Washington), Garland T Culbreth(University of Washington), Lydia M Haile(University of Washington), Quinn Rafferty(University of Washington), Justin Lo(University of Washington), Kai Fukutaki(University of Washington), Jessica A Cruz(University of Washington), Amanda Smith(University of Washington), Stein Emil Vollset(University of Washington), Peter Brooks(University of Washington), Marita Cross(University of Washington), Anthony D. Woolf(University of Washington), Hailey Hagins(University of Washington), Mohsen Abbasi‐Kangevari(University of Washington), Aidin Abedi(University of Washington), Ilana N. Ackerman(University of Washington), Hubert Amu(University of Washington), Benny Antony(University of Washington), Jalal Arabloo(University of Washington), Aleksandr Y. Aravkin(University of Washington), Ayele Mamo Argaw(University of Washington), Anton A Artamonov(University of Washington), Tahira Ashraf(University of Washington), Amadou Barrow(University of Washington), Lindsay Bearne(University of Washington), Isabela M. Benseñor(University of Washington), Alemshet Yirga Berhie(University of Washington), Nikha Bhardwaj(University of Washington), Pankaj Bhardwaj(University of Washington), Vijayalakshmi S Bhojaraja(University of Washington), Ali Bijani(University of Washington), Paul Svitil Briant(University of Washington), Andrew M. Briggs(University of Washington), Nadeem Shafique Butt(University of Washington), Jaykaran Charan(University of Washington), Vijay Kumar Chattu(University of Washington), Flavia Cicuttini(University of Washington), Kaleb Coberly(University of Washington), Omid Dadras(University of Washington), Xiaochen Dai(University of Washington), Lalit Dandona(University of Washington), Rakhi Dandona(University of Washington), Katie de Luca(University of Washington), Edgar Denova‐Gutiérrez(University of Washington), Samath Dhamminda Dharmaratne(University of Washington), Meghnath Dhimal(University of Washington), Mostafa Dianatinasab(University of Washington), Karsten E Dreinhoefer(University of Washington), Muhammed Elhadi(University of Washington), Umar Farooque(University of Washington), Hamid Reza Farpour(University of Washington), Irina Filip(University of Washington), Florian Fischer(University of Washington), Marisa Freitas(University of Washington), Balasankar Ganesan(University of Washington), Belete Negese(University of Washington), Tamiru Getachew(University of Washington), Seyyed‐Hadi Ghamari(University of Washington), Ahmad Ghashghaee(University of Washington), Tiffany K. Gill(University of Washington), Mahaveer Golechha(University of Washington), Davide Golinelli(University of Washington), Bhawna Gupta(University of Washington), Veer Bala Gupta(University of Washington), Vivek Gupta(University of Washington), Rasool Haddadi(University of Washington), Nima Hafezi‐Nejad(University of Washington), Rabih Halwani(University of Washington), Samer Hamidi(University of Washington), Asif Hanif(University of Washington), Netanja I. Harlianto(University of Washington), Josep María Haro(University of Washington), Jan Hartvigsen(University of Washington), Simon I Hay(University of Washington), Jeffrey J. Hébert(University of Washington), Golnaz Heidari(University of Washington), Mohammad‐Salar Hosseini(University of Washington), Mehdi Hosseinzadeh(University of Washington), Alexander Kevin Hsiao(University of Washington), Irena Ilić(University of Washington), Milena Ilić(University of Washington), Louis Jacob(University of Washington), Ranil Jayawardena(University of Washington), Ravi Prakash Jha(University of Washington), Jost B. Jonas(University of Washington), Nitin Joseph(University of Washington), Himal Kandel(University of Washington), Ibraheem M. Karaye(University of Washington), Mohammad Jobair Khan(University of Washington), Yun Jin Kim(University of Washington), Ali‐Asghar Kolahi(University of Washington), Oleksii Korzh(University of Washington), Rajasekaran Koteeswaran(University of Washington), Vijay Krishnamoorthy(University of Washington), G Anil Kumar(University of Washington), Narinder Kumar(University of Washington), Sang-woong Lee(University of Washington), Stephen S Lim(University of Washington), Stany W. Lobo(University of Washington), Giancarlo Lucchetti(University of Washington), Mohammad‐Reza Malekpour(University of Washington), Ahmad Azam Malik(University of Washington), Luiz Garcia Garcia Mandarano-Filho(University of Washington), Santi Martini(University of Washington), Alexios‐Fotios A. Mentis(University of Washington), Mohamed Kamal Mesregah(University of Washington), Tomislav Meštrović(University of Washington), Erkin М Мirrakhimov(University of Washington), Awoke Misganaw(University of Washington), Reza Mohammadpourhodki(University of Washington), Ali H. Mokdad(University of Washington), Sara Momtazmanesh(University of Washington), Shane D. Morrison(University of Washington), Christopher J L Murray(University of Washington), Hasan Nassereldine(University of Washington), Henok Biresaw Netsere, Sandhya Neupane Kandel(University of Washington), Mayowa Owolabi(University of Washington), Songhomitra Panda‐Jonas(University of Washington), Anamika Pandey(University of Washington), Shrikant Pawar(University of Washington), Paolo Pedersini(University of Washington), Jeevan Pereira(University of Washington), Amir Radfar(University of Washington), Mohammad‐Mahdi Rashidi(University of Washington), David Laith Rawaf(University of Washington), Salman Rawaf(University of Washington), Reza Rawassizadeh(University of Washington), Seyed-Mansoor Rayegani(University of Washington), Daniela Ribeiro(University of Washington), Leonardo Roever(University of Washington), Basema Saddik(University of Washington), Amirhossein Sahebkar(University of Washington), Sana Salehi(University of Washington), Lídia Sànchez-Riera(University of Washington), Francesco Sanmarchi(University of Washington), Milena M Santric-Milicevic(University of Washington), Saeed Shahabi(University of Washington), Masood Ali Shaikh(University of Washington), Elaheh Shaker(University of Washington), Mohammed Shannawaz(University of Washington), R. K. Sharma(University of Washington), Saurab Sharma(University of Washington), Jeevan K. Shetty(University of Washington), Rahman Shiri(University of Washington), Parnian Shobeiri(University of Washington), Diego Augusto Santos Silva(University of Washington), Ambrish Singh(University of Washington), Jasvinder A. Singh(University of Washington), Surjit Singh(University of Washington), Søren Thorgaard Skou(University of Washington), Helen Slater(University of Washington), Mohammad Sadegh Soltani‐Zangbar(University of Washington), А. В. Стародубова(University of Washington), Arash Tehrani‐Banihashemi(University of Washington), Sahel Valadan Tahbaz(University of Washington), Pascual Valdéz(University of Washington), Bay Vo(University of Washington), Linh Gia Vu(University of Washington), Yuan‐Pang Wang(University of Washington), Seyed Hossein Yahyazadeh Jabbari(University of Washington), Naohiro Yonemoto(University of Washington), Ismaeel Yunusa(University of Washington), Lyn March(University of Washington), Kanyin Liane Ong(University of Washington), Theo Vos(University of Washington), Jacek A Kopec(University of Washington)
The Lancet Rheumatology
August 21, 2023
10.1016/s2665-9913(23)00163-7
Cited by 1,643Open Access
Full Text

Abstract

<h2>Summary</h2><h3>Background</h3> Osteoarthritis is the most common form of arthritis in adults, characterised by chronic pain and loss of mobility. Osteoarthritis most frequently occurs after age 40 years and prevalence increases steeply with age. WHO has designated 2021–30 the decade of healthy ageing, which highlights the need to address diseases such as osteoarthritis, which strongly affect functional ability and quality of life. Osteoarthritis can coexist with, and negatively effect, other chronic conditions. Here we estimate the burden of hand, hip, knee, and other sites of osteoarthritis across geographies, age, sex, and time, with forecasts of prevalence to 2050. <h3>Methods</h3> In this systematic analysis for the Global Burden of Disease Study, osteoarthritis prevalence in 204 countries and territories from 1990 to 2020 was estimated using data from population-based surveys from 26 countries for knee osteoarthritis, 23 countries for hip osteoarthritis, 42 countries for hand osteoarthritis, and US insurance claims for all of the osteoarthritis sites, including the other types of osteoarthritis category. The reference case definition was symptomatic, radiographically confirmed osteoarthritis. Studies using alternative definitions from the reference case definition (for example self-reported osteoarthritis) were adjusted to reference using regression models. Osteoarthritis severity distribution was obtained from a pooled meta-analysis of sources using the Western Ontario and McMaster Universities Arthritis Index. Final prevalence estimates were multiplied by disability weights to calculate years lived with disability (YLDs). Prevalence was forecast to 2050 using a mixed-effects model. <h3>Findings</h3> Globally, 595 million (95% uncertainty interval 535–656) people had osteoarthritis in 2020, equal to 7·6% (95% UI 6·8–8·4) of the global population, and an increase of 132·2% (130·3–134·1) in total cases since 1990. Compared with 2020, cases of osteoarthritis are projected to increase 74·9% (59·4–89·9) for knee, 48·6% (35·9–67·1) for hand, 78·6% (57·7–105·3) for hip, and 95·1% (68·1–135·0) for other types of osteoarthritis by 2050. The global age-standardised rate of YLDs for total osteoarthritis was 255·0 YLDs (119·7–557·2) per 100 000 in 2020, a 9·5% (8·6–10·1) increase from 1990 (233·0 YLDs per 100 000, 109·3–510·8). For adults aged 70 years and older, osteoarthritis was the seventh ranked cause of YLDs. Age-standardised prevalence in 2020 was more than 5·5% in all world regions, ranging from 5677·4 (5029·8–6318·1) per 100 000 in southeast Asia to 8632·7 (7852·0–9469·1) per 100 000 in high-income Asia Pacific. Knee was the most common site for osteoarthritis. High BMI contributed to 20·4% (95% UI –1·7 to 36·6) of osteoarthritis. Potentially modifiable risk factors for osteoarthritis such as recreational injury prevention and occupational hazards have not yet been explored in GBD modelling. <h3>Interpretation</h3> Age-standardised YLDs attributable to osteoarthritis are continuing to rise and will lead to substantial increases in case numbers because of population growth and ageing, and because there is no effective cure for osteoarthritis. The demand on health systems for care of patients with osteoarthritis, including joint replacements, which are highly effective for late stage osteoarthritis in hips and knees, will rise in all regions, but might be out of reach and lead to further health inequity for individuals and countries unable to afford them. Much more can and should be done to prevent people getting to that late stage. <h3>Funding</h3> Bill & Melinda Gates Foundation, Institute of Bone and Joint Research, and Global Alliance for Musculoskeletal Health.

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