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Extended Report
The global burden of hip and knee osteoarthritis: estimates from the Global Burden of Disease 2010 study
  1. Marita Cross1,
  2. Emma Smith1,
  3. Damian Hoy2,
  4. Sandra Nolte3,4,
  5. Ilana Ackerman5,
  6. Marlene Fransen6,
  7. Lisa Bridgett6,
  8. Sean Williams7,
  9. Francis Guillemin8,
  10. Catherine L Hill9,10,
  11. Laura L. Laslett11,
  12. Graeme Jones11,
  13. Flavia Cicuttini12,
  14. Richard Osborne13,
  15. Theo Vos2,14,
  16. Rachelle Buchbinder12,15,
  17. Anthony Woolf16,
  18. Lyn March1
  1. 1University of Sydney, Institute of Bone & Joint Research, Royal North Shore Hospital, St Leonards, New South Wales, Australia
  2. 2University of Queensland, School of Population Health, Herston, Queensland, Australia
  3. 3Department of Psychosomatic Medicine, Medical Clinic, Charité—Universitätsmedizin Berlin, Berlin, Germany
  4. 4Population Health Strategic Research Centre, School of Health and Social Development, Deakin University, Burwood, Victoria, Australia
  5. 5Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Melbourne EpiCentre, Parkville, Victoria, Australia
  6. 6Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia
  7. 7School of Medicine, University of Western Sydney, Campbelltown, New South Wales, Australia
  8. 8EA 4360 APEMAC, Université de Lorraine, Nancy, France
  9. 9Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, South Australia, Australia
  10. 10The Health Observatory, University of Adelaide, Adelaide, South Australia, Australia
  11. 11Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
  12. 12Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  13. 13Faculty of Health, Public Health Innovation, School of Health and Social Development, Deakin University, Melbourne, Victoria, Australia
  14. 14Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
  15. 15Monash Department of Clinical Epidemiology, Cabrini Institute, Melbourne, Australia
  16. 16Department of Rheumatology, Royal Cornwall Hospital, Truro, UK
  1. Correspondence to Professor Lyn March, University of Sydney, Institute of Bone & Joint Research, 7C Administration, Royal North Shore Hospital, St Leonards, NSW 2065, Australia; lyn.march{at}


Objective 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.

Methods 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).

Results 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).

Conclusions 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
  • Osteoarthritis
  • Knee Osteoarthritis

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