Global, regional, and national burden of osteoarthritis, 1990–2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021
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Résumé
Background 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. Methods 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. Findings 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. Interpretation 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. Funding Bill & Melinda Gates Foundation, Institute of Bone and Joint Research, and Global Alliance for Musculoskeletal Health.
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La notice
- Revue
- The Lancet Rheumatology
- Thématique
- Osteoarthritis Treatment and Mechanisms
- Domaine
- Medicine
- Établissements canadiens
- —
- Organismes subventionnaires
- International Door AssociationFaculty of Medicine and Health, University of SydneyUniversity of Health and Allied SciencesRede de Química e TecnologiaNational Center of Neurology and PsychiatryMadda Walabu UniversityUniversity of South CarolinaUniversitetet i BergenLaboratório Associado para a Química VerdeUniversity of PeradeniyaBahir Dar UniversityXiamen UniversityUniversity of TorontoUniversidade Federal de Santa CatarinaNational Health and Medical Research CouncilUniversidade de São PauloShiraz University of Medical SciencesResearch Management Centre, International Islamic University MalaysiaMenzies Institute for Medical ResearchShiraz UniversityKing Abdulaziz UniversityConselho Nacional de Desenvolvimento Científico e TecnológicoMinistero della SaluteIslamic Azad UniversityKasturba Medical College, ManipalBill and Melinda Gates FoundationCurtin University of TechnologyRussian Academy of SciencesUniversiteit MaastrichtMinistarstvo Prosvete, Nauke i Tehnološkog RazvojaRoyal College of Surgeons in IrelandPublic Health Foundation of IndiaMedical Research CouncilIndian Council of Medical ResearchNational Institute for Health and Care ResearchHøgskulen på VestlandetSaveetha Dental CollegeUniversity of TasmaniaMonash UniversityPirogov Russian National Research Medical UniversityManipal Academy of Higher EducationUniversity of Southern CaliforniaFondation de la recherche en santé du Nouveau-BrunswickBabol University of Medical SciencesTehran University of Medical Sciences and Health ServicesIran University of Medical SciencesU.S. Department of Veterans AffairsInternational Association for the Study of PainKaiser Permanente
- Mots-clés
- Burden of diseaseDiseaseMedicineDisease burdenOsteoarthritisInternal medicineAlternative medicinePathology
- Résumé présent dans OpenAlex
- oui