Prevalence Trends of Site-Specific Osteoarthritis From 1990 to 2019: Findings From the Global Burden of Disease Study 2019

Abstract

Objective: To estimate systematic and anatomic site-specific age-standardized prevalence rates (ASRs) and analyze the secular trends of osteoarthritis (OA) at global, regional, and national levels.

Methods: Data were derived from the Global Burden of Disease Study 2019. ASRs and their estimated annual percentage changes (EAPCs) were used to describe the secular trends of OA according to age group, sex, region, country, and territory, as well as the joints involved.

Results: Globally, prevalent cases of OA increased by 113.25%, from 247.51 million in 1990 to 527.81 million in 2019. ASRs were 6,173.38 per 100,000 in 1990 and 6,348.25 per 100,000 in 2019, with an average annual increase of 0.12% (95% confidence interval [95% CI] 0.11%, 0.14%). The ASR of OA increased for the knee, hip, and other joints, but decreased for the hand, with EAPCs of 0.32 (95% CI 0.29, 0.34), 0.28 (95% CI 0.26, 0.31), 0.18 (95% CI 0.18, 0.19), and -0.36 (95% CI -0.38, -0.33), respectively. OA prevalence increased with age and revealed female preponderance, geographic diversity, and disparity with regard to anatomic site. OA of the knee contributed the most to the overall burden, while OA of the hip had the highest EAPC in most regions.

Conclusion: OA has remained a major public health concern worldwide over the past decades. The prevalence of OA has increased and diversified by geographic location and affected joint. Prevention and early treatment are pivotal to mitigating the growing burden of OA.

Figure 1

Total number of prevalent osteoarthritis (OA) cases and number of prevalent OA cases according to the affected joint, globally, by Socio‐demographic Index (SDI) category (low, low‐middle, middle, high‐middle, and high) and by geographic region, for both sexes combined. A, Number of prevalent OA cases for each year from 1990 to 2019, globally and by SDI category. Insets show the same data at a magnified scale. B, Number of prevalent OA cases in 1990 and 2019 in the 21 indicated geographic regions. For each region, the left column shows data for 1990 and the right column shows data for 2019. Inset shows data for some regions at a magnified scale. Color figure can be viewed in the online issue, which is available at http://onlinelibrary.wiley.com/doi/10.1002/art.42089/abstract.

Figure 2

Prevalence of osteoarthritis (OA) for both sexes combined in 204 countries and territories. A, Age‐standardized prevalence rate (ASR) of OA in 2019. B, Percentage change in prevalent cases of OA between 1990 and 2019. C, Estimated annual percentage change (EAPC) of OA from 1990 to 2019.

Figure 3

Global total number of prevalent osteoarthritis (OA) cases and number of prevalent OA cases according to the affected joint, by sex and age group. A, Global number of prevalent OA cases and age‐standardized prevalence rate (ASR) by sex and age group. For each age group, the left column shows data for prevalent cases in 1990 and the right column shows data for prevalent cases in 2019. Broken lines indicate the global ASR of OA in 1990, and solid lines indicate the global ASR of OA in 2019. B, Sex differences in global prevalent OA cases by age group in 2019. Color figure can be viewed in the online issue, which is available at http://onlinelibrary.wiley.com/doi/10.1002/art.42089/abstract.

Figure 4

A, Estimated annual percentage change (EAPC) in total osteoarthritis (OA) and according to the affected joint from 1990 to 2019, globally, by Socio‐demographic Index (SDI) category and by geographic region, for both sexes combined. Data for OA overall and for the affected sites with absolute maximum of EAPC are presented for each category. B and C, Correlation between age‐standardized prevalence rate (ASR) of OA and SDI in 1990 (B) and 2019 (C). Circles represent the number of prevalent OA cases in individual countries or territories. 95% CI = 95% confidence interval. Color figure can be viewed in the online issue, which is available at http://onlinelibrary.wiley.com/doi/10.1002/art.42089/abstract.

Figure 5

Percentage of total prevalent osteoarthritis (OA) cases accounted for by OA at each site (knee, hip, hand, or other) in 1990 and 2019, globally, by Socio‐demographic Index (SDI) category and by geographic region, for both sexes combined. Color figure can be viewed in the online issue, which is available at http://onlinelibrary.wiley.com/doi/10.1002/art.42089/abstract.