Global, regional and national burden of knee osteoarthritis 1990–2021: A systematic analysis of the Global Burden of Disease study 2021

Abstract

Objective

The systematic analysis aimed to assess the levels and trends of knee osteoarthritis (KOA) in 204 countries and territories from 1990 to 2021.

Methods

We analyzed the data on the Global Burden of Diseases 2021 and reported the KOA burden and the trends from 1990–2021 by age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR) and age-standardized disability-adjusted life years (DALYs) rate (ASDAR) with 95 % uncertainty intervals (UIs). All estimates were presented as counts and age-standardized rates per 100,000 people, calculating the estimating average annual percent change (EAPCs).

Results

From 1990 to 2021, the KOA burden still showed an increasing trend globally, faster in females than males; the 35–39 years population has faster KOA symptoms, and 45–49 years have faster prevalence and DALYs. The high-middle SDI regions are experiencing the fastest increase. East Asia has the fastest growth, and North America has shown a stable trend with no change. The top 9 fastest growing countries and territories were Oman, Equatorial Guinea, Thailand, Saudi Arabia, Sudan, China, Taiwan (Province of China), Maldives, and Pakistan. By 2050 of prediction, there may be an obvious decreasing trend in KOA burden. Frontier analysis indicates the presence of unrealized opportunities to close the KOA burden gap in most countries and territories. Decomposition analyses indicate that population growth accounted for >70 % of the global KOA burden. SDI level was positively associated with KOA burden increasing, and ASIR or HDI was not associated with the burden EAPC.

Conclusion

KOA is still a major global health challenge. Although there is variation between countries and regions, most countries' KOA burden is increasing, especially among females and young adults.