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Ann Rheum Dis. 2014 Jul;73(7):1323-30. doi: 10.1136/annrheumdis-2013-204763. Epub 2014 Feb 19.

The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study.

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University of Sydney, Institute of Bone & Joint Research, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
University of Queensland, School of Population Health, Herston, Queensland, Australia.
Department of Psychosomatic Medicine, Medical Clinic, Charité-Universitätsmedizin Berlin, Berlin, Germany Population Health Strategic Research Centre, School of Health and Social Development, Deakin University, Burwood, Victoria, Australia.
Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Melbourne EpiCentre, Parkville, Victoria, Australia.
Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia.
School of Medicine, University of Western Sydney, Campbelltown, New South Wales, Australia.
EA 4360 APEMAC, Université de Lorraine, Nancy, France.
Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, South Australia, Australia The Health Observatory, University of Adelaide, Adelaide, South Australia, Australia.
Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia.
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Faculty of Health, Public Health Innovation, School of Health and Social Development, Deakin University, Melbourne, Victoria, Australia.
University of Queensland, School of Population Health, Herston, Queensland, Australia Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia Monash Department of Clinical Epidemiology, Cabrini Institute, Melbourne, Australia.
Department of Rheumatology, Royal Cornwall Hospital, Truro, UK.



To estimate the global burden of hip and knee osteoarthritis (OA) as part of the Global Burden of Disease 2010 study and to explore how the burden of hip and knee OA compares with other conditions.


Systematic reviews were conducted to source age-specific and sex-specific epidemiological data for hip and knee OA prevalence, incidence and mortality risk. The prevalence and incidence of symptomatic, radiographic and self-reported hip or knee OA were included. Three levels of severity were defined to derive disability weights (DWs) and severity distribution (proportion with mild, moderate and severe OA). The prevalence by country and region was multiplied by the severity distribution and the appropriate disability weight to calculate years of life lived with disability (YLDs). As there are no deaths directly attributed to OA, YLDs equate disability-adjusted life years (DALYs).


Globally, of the 291 conditions, hip and knee OA was ranked as the 11th highest contributor to global disability and 38th highest in DALYs. The global age-standardised prevalence of knee OA was 3.8% (95% uncertainty interval (UI) 3.6% to 4.1%) and hip OA was 0.85% (95% UI 0.74% to 1.02%), with no discernible change from 1990 to 2010. Prevalence was higher in females than males. YLDs for hip and knee OA increased from 10.5 million in 1990 (0.42% of total DALYs) to 17.1 million in 2010 (0.69% of total DALYs).


Hip and knee OA is one of the leading causes of global disability. Methodological issues within this study make it highly likely that the real burden of OA has been underestimated. With the aging and increasing obesity of the world's population, health professions need to prepare for a large increase in the demand for health services to treat hip and knee OA.


Epidemiology; Knee Osteoarthritis; Osteoarthritis

[Indexed for MEDLINE]

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