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Background <p>Osteoarthritis (OA) is a leading cause of disability worldwide, yet global estimates of lifetime risk remain limited. This study aims to provide comprehensive global, regional, and national lifetime risk estimates for OA, including knee, hand, and hip subtypes, from 1990 to 2021.</p> Methods <p>Using data from the Global Burden of Disease (GBD) Study 2021, we estimated the lifetime risk of developing OA from age 20 onwards, stratified by sex, location, and Socio-demographic Index (SDI). Average annual percentage change (AAPC) was also calculated. Spatial heterogeneity in 2021 lifetime risks and their AAPCs was evaluated using the Factor Detector of the Geographic Detector method, with q-statistics quantifying the explanatory power of demographic, socioeconomic, health system and OA-related risk factors. </p> Results <p>In 2021, the global lifetime risk of OA was 14.21% (95% confidence interval: 14.21%, 14.22%), with knee OA at 9.31% (95% CI: 9.31%, 9.32%), hand OA at 3.45% (95% CI: 3.45%, 3.46%), and hip OA at 0.71% (95% CI: 0.71%, 0.71%). Lifetime risk increased with higher socio-demographic Index (SDI), from 11.62% in low-SDI regions to 16.10% in high-SDI regions. The highest risk was observed in the High-income Asia Pacific region (18.10%), led by the Republic of Korea (21.20%). Between 1990 and 2021, global lifetime OA risk increased with an AAPC of 0.30% (95% CI: 0.30%, 0.30%), with the most notable increases in East Asia (AAPC: 0.53%). Spatial heterogeneity analysis revealed that the historical proportions employed in agriculture and with upper secondary education had the strongest associations with 2021 lifetime risks and their trends (q-statistics up to 0.84), followed by life expectancy, SDI, and health-system indicators.</p> Conclusions <p>In 2021, 1 in 7 individuals globally were projected to develop OA, with the highest risks in high-SDI regions. The steady rise in OA risk, especially in East Asia, highlights the need for targeted public health strategies that focus on prevention, early diagnosis, and ensuring equitable access to treatment to mitigate the increasing OA burden.</p>

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Global, regional, and country-specific lifetime risks of osteoarthritis, 1990–2021: a systematic analysis for the global burden of disease study 2021

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  • 发表日期：

    2025年7月22日

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  • Xinge Zhang,
  • Chuiguo Huang,
  • Zhaolan Hu,
  • Yejun Tan,
  • Pengfei Wang,
  • Lemei Zhu,
  • Jin Kang

摘要

Background

Osteoarthritis (OA) is a leading cause of disability worldwide, yet global estimates of lifetime risk remain limited. This study aims to provide comprehensive global, regional, and national lifetime risk estimates for OA, including knee, hand, and hip subtypes, from 1990 to 2021.

Methods

Using data from the Global Burden of Disease (GBD) Study 2021, we estimated the lifetime risk of developing OA from age 20 onwards, stratified by sex, location, and Socio-demographic Index (SDI). Average annual percentage change (AAPC) was also calculated. Spatial heterogeneity in 2021 lifetime risks and their AAPCs was evaluated using the Factor Detector of the Geographic Detector method, with q-statistics quantifying the explanatory power of demographic, socioeconomic, health system and OA-related risk factors.

Results

In 2021, the global lifetime risk of OA was 14.21% (95% confidence interval: 14.21%, 14.22%), with knee OA at 9.31% (95% CI: 9.31%, 9.32%), hand OA at 3.45% (95% CI: 3.45%, 3.46%), and hip OA at 0.71% (95% CI: 0.71%, 0.71%). Lifetime risk increased with higher socio-demographic Index (SDI), from 11.62% in low-SDI regions to 16.10% in high-SDI regions. The highest risk was observed in the High-income Asia Pacific region (18.10%), led by the Republic of Korea (21.20%). Between 1990 and 2021, global lifetime OA risk increased with an AAPC of 0.30% (95% CI: 0.30%, 0.30%), with the most notable increases in East Asia (AAPC: 0.53%). Spatial heterogeneity analysis revealed that the historical proportions employed in agriculture and with upper secondary education had the strongest associations with 2021 lifetime risks and their trends (q-statistics up to 0.84), followed by life expectancy, SDI, and health-system indicators.

Conclusions

In 2021, 1 in 7 individuals globally were projected to develop OA, with the highest risks in high-SDI regions. The steady rise in OA risk, especially in East Asia, highlights the need for targeted public health strategies that focus on prevention, early diagnosis, and ensuring equitable access to treatment to mitigate the increasing OA burden.