Background: Knee osteoarthritis (OA), a leading cause of disability, disproportionately affects women and the elderly, contributing significantly to health burdens. This study aims to analyze the temporal trend and future projection of knee OA burden in China, using data from the Global Burden of Disease (GBD) 2021.
Methods: The research employed age-period-cohort (APC) and autoregressive integrated moving average (ARIMA) models to examine the effects of age, period, and cohort on the incidence and disability-adjusted life years (DALYs) of knee OA from 1990 to 2021, with projections for the next 15 years.
Results: Findings show a substantial increase in knee OA incidence and DALYs over the past three decades, particularly among women, with a notable age-dependent rise. The ARIMA model predicts a gradual decline in knee OA incidence and DALYs after 2021, potentially due to healthcare reforms and preventive strategies.
Conclusion: The study underscores the growing healthcare burden of knee OA in China and highlights the need for effective prevention, early diagnosis, and improved healthcare infrastructure to manage this increasing public health issue.
| [1] |
J. Dhillon, M. J. Kraeutler, J. W. Belk, et al., “Effects of Running on the Development of Knee Osteoarthritis: An Updated Systematic Review at Short-Term Follow-Up,” Orthopaedic Journal of Sports Medicine 11 (2023): 23259671231152900.
|
| [2] |
M. Zhang, M. Nie, X. Qi, et al., “A Strong Correlation Between the Severity of Flatfoot and Symptoms of Knee Osteoarthritis in 95 Patients,” Frontiers in Surgery 9 (2022): 936720.
|
| [3] |
S. Lin, B. Wu, X. Hu, and H. Lu, “Sirtuin 4 (Sirt4) Downregulation Contributes to Chondrocyte Senescence and Osteoarthritis via Mediating Mitochondrial Dysfunction,” International Journal of Biological Sciences 20 (2024): 1256–1278.
|
| [4] |
R. R. Bannuru, M. C. Osani, E. E. Vaysbrot, et al., “OARSI Guidelines for the Non-Surgical Management of Knee, Hip, and Polyarticular Osteoarthritis,” Osteoarthritis and Cartilage 27 (2019): 1578–1589.
|
| [5] |
GBD 2021 Osteoarthritis Collaborators, “Global, Regional, and National Burden of Osteoarthritis, 1990–2020 and Projections to 2050: A Systematic Analysis for the Global Burden of Disease Study 2021,” Lancet Rheumatololgy 5 (2023): e508–e522.
|
| [6] |
M. J. Richard, J. B. Driban, and T. E. McAlindon, “Pharmaceutical Treatment of Osteoarthritis,” Osteoarthritis and Cartilage 31 (2023): 458–466.
|
| [7] |
M.-N. Xu, J.-Y. Zhang, H. Yang, et al., “Incidence of Rhegmatogenous Retinal Detachments Is Increasing in Wenzhou, China,” International Journal of Ophthalmology 16 (2023): 260–266.
|
| [8] |
S. Altwicker-Hámori and M. Stucki, “Factors Associated With the Choice of Supplementary Hospital Insurance in Switzerland – An Analysis of the Swiss Health Survey,” BMC Health Services Research 23 (2023): 264.
|
| [9] |
GBD 2021 Lower Respiratory Infections and Antimicrobial Resistance Collaborators, “Global, Regional, and National Incidence and Mortality Burden of Non-COVID-19 Lower Respiratory Infections and Aetiologies, 1990–2021: A Systematic Analysis From the Global Burden of Disease Study 2021,” Lancet Infectious Diseases 24 (2024): 974–1002.
|
| [10] |
GBD 2021 Diseases and Injuries Collaborators, “Global Incidence, Prevalence, Years Lived With Disability (YLDs), Disability-Adjusted Life-Years (DALYs), and Healthy Life Expectancy (HALE) for 371 Diseases and Injuries in 204 Countries and Territories and 811 Subnational Locations, 1990–2021: A Systematic Analysis for the Global Burden of Disease Study 2021,” Lancet 403 (2024): 2133–2161.
|
| [11] |
J. H. Kellgren and J. S. Lawrence, “Radiological Assessment of Osteo-Arthrosis,” Annals of the Rheumatic Diseases 16 (1957): 494–502.
|
| [12] |
H. Li, W. Kong, Y. Liang, and H. Sun, “Burden of Osteoarthritis in China, 1990-2019: Findings From the Global Burden of Disease Study 2019,” Clinical Rheumatology 43 (2024): 1189–1197.
|
| [13] |
Y. Li, Y. Ning, B. Shen, et al., “Temporal Trends in Prevalence and Mortality for Chronic Kidney Disease in China From 1990 to 2019: An Analysis of the Global Burden of Disease Study 2019,” Clinical Kidney Journal 16 (2023): 312–321.
|
| [14] |
H. V. Nguyen, M. A. Naeem, N. Wichitaksorn, and R. Pears, “A Smart System for Short-Term Price Prediction Using Time Series Models,” Computers and Electrical Engineering 76 (2019): 339–352.
|
| [15] |
X. Zhao, C. Li, G. Ding, et al., “The Burden of Alzheimer's Disease Mortality in the United States, 1999–2018,” Journal of Alzheimers Disease 82 (2021): 803–813.
|
| [16] |
A. O. Alshammari, N. A. Altamimi, F. F. Alshammari, et al., “Awareness About Total Knee Arthroplasty Among Hail Population,” Cureus 15, no. 1 (2023): e33260.
|
| [17] |
S. Safiri, A. A. Kolahi, E. Smith, et al., “Global, Regional and National Burden of Osteoarthritis 1990-2017: A Systematic Analysis of the Global Burden of Disease Study 2017,” Annals of the Rheumatic Diseases 79 (2020): 819–828.
|
| [18] |
A. A. Kiadaliri, L. S. Lohmander, M. Moradi-Lakeh, I. F. Petersson, and M. Englund, “High and Rising Burden of Hip and Knee Osteoarthritis in the Nordic Region, 1990-2015,” Acta Orthopaedica 89 (2018): 177–183.
|
| [19] |
M. Cross, E. Smith, D. Hoy, et al., “The Global Burden of Hip and Knee Osteoarthritis: Estimates From the Global Burden of Disease 2010 Study,” Annals of the Rheumatic Diseases 73 (2014): 1323–1330.
|
| [20] |
G. Constantino de Campos, R. Mundi, C. Whittington, M.-J. Toutounji, W. Ngai, and B. Sheehan, “Osteoarthritis, Mobility-Related Comorbidities and Mortality: An Overview of Meta-Analyses,” Therapeutic Advances in Musculoskeletal Disease 12 (2020): 1759720X20981219.
|
| [21] |
P. P. Geusens and J. P. van den Bergh, “Osteoporosis and Osteoarthritis: Shared Mechanisms and Epidemiology,” Current Opinion in Rheumatology 28 (2016): 97–103.
|
| [22] |
S. Rahini and R. S. Hadaye, “A Cross-Sectional Study to Estimate the Proportion and Ascertain Risk Factors for Osteoarthritis Knee Among Women Above 45 Years of Age Attending a Tertiary Care Hospital,” Indian Journal of Community Medicine 49 (2024): 209–213.
|
| [23] |
S. B. Baer, A. D. Dorn, and D. M. Osborne, “Sex Differences in Response to Obesity and Caloric Restriction on Cognition and Hippocampal Measures of Autophagic-Lysosomal Transcripts and Signaling Pathways,” BMC Neuroscience 25 (2024): 1.
|
| [24] |
Y. Wang, F. Zhang, and C. Li, “Effect of Individualized Narrative Nursing Mode on Recovery of Elderly Patients With Fracture Complicated With Cerebrovascular Accident,” Medicine (Baltimore) 103 (2024): e36901.
|
| [25] |
J. Ho, C. C. H. Mak, V. Sharma, To K, and W. Khan, “Mendelian Randomization Studies of Lifestyle-Related Risk Factors for Osteoarthritis: A PRISMA Review and Meta-Analysis,” International Journal of Molecular Sciences 23 (2022): 11906.
|
| [26] |
S. Tang, J. Meng, X. Zhao, and W. Sun, “Trends of Ischemic Heart Disease Mortality Attributable to Smoking in the Five Countries With the Highest Number of Smokers During 1990–2019: An Age-Period-Cohort Analysis,” Archives of Medical Science 20 (2024): 43–53.
|
| [27] |
Z. Wang, E. Guo, B. Yang, et al., “Trends and Age-Period-Cohort Effects on Mortality of the Three Major Gynecologic Cancers in China From 1990 to 2019: Cervical, Ovarian and Uterine Cancer,” Gynecologic Oncology 163 (2021): 358–363.
|
| [28] |
Z. Zafari, K. M. Keyes, B. Jiao, S. Z. Williams, and P. A. Muennig, “Differences Between Blacks and Whites in Well-Being, Beliefs, Emotional States, Behaviors and Survival, 1978-2014,” PLoS One 15 (2020): e0238919.
|
| [29] |
J. Yang, J. G. Siri, J. V. Remais, et al., “The Tsinghua-Lancet Commission on Healthy Cities in China: Unlocking the Power of Cities for a Healthy China,” Lancet 391, no. 10135 (2018): 2140–2184.
|
Rights & permissions
2026 The Author(s). Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.
PDF
(416KB)
