BACKGROUND
Osteoarthritis (OA) is the most common cause of adult activity limitation and a major cause of deformity in aging people, therefore gradually becomes a global public health issue.
OBJECTIVE
We here provide a comprehensive evaluation of the trends and cross-country inequalities of global OA burden over the last 30 years.
METHODS
The estimates and 95% uncertainty interval (UI) for incidence, prevalence, and disability-adjusted life-years (DALYs) of OA were extracted from Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 as measures of OA burden. We described OA epidemiology at global, regional, and national levels, analyzed 1990-2019 trends in OA burden from overall, local, and multi-dimension scopes, decomposed OA DALYs, and quantified cross-country inequalities in OA DALYs.
RESULTS
GBD 2019 estimated 527,811,871 (95% UI: 478,667,549 to 584,793,491) prevalent cases, 41,467,542 (95% UI: 36,875,471 to 46,438,409) incident cases and 18,948,965 (95% UI:9,571,298 to 37,659,660) DALYs of OA occurred worldwide in 2019, with the highest cases in East Asia and highest age-standardized rate (ASR) in high-income North America. The global burden of OA increased overall from 1990 to 2019 with the fastest growth observed in the first decade of the 21st century, although there were variations in incidence, prevalence and DALYs of OA across countries. Decomposition analysis revealed that OA knee (62.78%), women (60.47%), and middle sociodemographic index (SDI) quintile region (32.35%) were responsible for the most significant DALYs, whose changes were primarily driven by population growth and aging. A significant increase in SDI-related inequalities was detected, and the gap in DALYs between the highest SDI countries and the lowest SDI countries increased from 179.5 (95% CI: 149.3 to 209.8) per 100,000 in 1990 to 341.9 (95% CI: 309.5 to 374.4) per 100,000 in 2019.
CONCLUSIONS
From 1990 to 2019, there was a significant increase in OA burden globally (particularly in OA knee burden), which was primarily driven by population growth and aging. Countries with high SDI shouldered disproportionately high OA burden, and the magnitude of the SDI-related inequalities across countries increased over time.