Osteoarthritis (OA) is a disabling condition that has a significant negative impact on those affected, healthcare services, and the economy. Obesity is a predisposing factor since most MRI studies noticed that a leaner body consititution is positively associated with cartilage thickness. A constant physical exercise is also protective in cartilage degeneration and avoiding smoking may represent a further protective factor on the development od osteoarthritis. Much of the burden is hip and knee-related, with the later stages of the disease often requiring joint replacement. Some recent reviews of national studies have described the burden of OA, but no comprehensive data on all countries were provided. The prevalence and incidence of osteoarthritis represent a growing burden worldwide that is only expected to increase, according to an analysis of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017. The researchers say that in most countries, extended lifespans mean the burden will only continue to increase and that more awareness is needed among policymakers to inform future efforts to limit it.
While one study of 2000 to 2015 data from the WHO Burden of Diseases Database reported on the worldwide impact of musculoskeletal diseases, it did not look at OA specifically. Now, a team from the University of Sidney have used the GBD 2017 Study to assess the regional, national and global prevalence of OA between 1990 and 2017, as well as annual incidence and years lived with disability (YLD), to provide updated information about the disease burden. The researchers say the GBD 2017 Study is the most extensive, most detailed study so far to look at worldwide epidemiologic trends, covering risk factors and causes of death for 359 diseases and injuries across 195 countries and 28 regions. Overall, the worldwide prevalence of hip and knee OA was approximately 303.1 million, with an age-standardized estimated prevalence of 3754.2, an annual incidence of 181.2, and a YLD rate of 111.8 per 100,000. Compared with the figures for 1990, the age-standardized estimated prevalence was up by 9.3%, the annual incidence was up by 8.2%, and the YLD rate was up by 9.6%.
In 2017, the age-standardized prevalence estimates were highest in the United States, at 6,128.1 per 100,000 people, American Samoa (5,281), and Kuwait (5234.6). The estimates were lowest for Taiwan (2090.3), North Korea (2290.7), and Madagascar (2353.5). Between 1990 and 2017, the most significant increase in age-standardized prevalence was observed for Oman (29.6%), Equatorial Guinea (28.6%), and the United States (23.2%). The global prevalence of OA was higher among women than among men, increased with age and peaked among both men and women aged older than 95 years in 2017. The researchers recommend that future efforts to minimize the burden of OA should focus on increased awareness, particularly regarding risk factors, early diagnosis, and therapy. They also say healthcare infrastructures need improving to help better manage the ever-increasing number of OA patients. Although there is variation between countries in prevalence, incidence, and years of disability due to the condition, its burden is increasing in most countries, especially among women.
Dr. Marita Cross (University of Sydney) commented: “This trend is expected to continue as the aging of the global population is rising. Improving population and policymaker awareness of risk factors, including overweight and injury, and the importance and benefits of management of OA, together with providing health services for an increasing number of people living with OA, are recommended for management of the future burden of this condition. Moreover, worldwide OA burden was reported using the Global Burden of Disease 2010 Study, but country-level information was not reported, and these overall osteoarthritis burden estimates need to be updated from the 2010 estimates. Continuing to expand OA population-based data collection at the national level is essential to monitor the disease burden and to further deal with the need for better care”.
- Edited by Dr. Gianfrancesco Cormaci, PhD, specialist in Clinical Biochemistry.
Safiri S et al., Cross M. Annals Rheum Dis 2020 May 12.
Cross M et al. Rheumatology (Oxford). 2019 Dec 31.
Meng T et al. Osteoarthr Cartil 2018; 26(8):1055-1062.
Antony B et al. Arthritis Care Res 2016; 68(4):517-25.
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