Article Text

Download PDFPDF
Global, regional and national burden of osteoarthritis 1990-2017: a systematic analysis of the Global Burden of Disease Study 2017
  1. Saeid Safiri1,2,3,
  2. Ali-Asghar Kolahi4,
  3. Emma Smith5,6,
  4. Catherine Hill7,8,
  5. Deepti Bettampadi9,
  6. Mohammad Ali Mansournia10,
  7. Damian Hoy5,11,12,
  8. Ahad Ashrafi-Asgarabad13,
  9. Mahdi Sepidarkish14,
  10. Amir Almasi-Hashiani15,
  11. Gary Collins16,
  12. Jay Kaufman17,
  13. Mostafa Qorbani18,
  14. Maziar Moradi-Lakeh19,
  15. Anthony D Woolf12,20,
  16. Francis Guillemin21,
  17. Lyn March5,12,22,
  18. Marita Cross5
  1. 1 Immunology Research Center, Department of Community Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
  2. 2 Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  3. 3 Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
  4. 4 Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5 Institute of Bone and Joint Research, Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  6. 6 Pain Management Research Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  7. 7 Rheumatology Department, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
  8. 8 The University of Adelaide, Adelaide, South Australia, Australia
  9. 9 Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
  10. 10 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  11. 11 School of Population Health, University of Queensland, Herston, Queensland, Australia
  12. 12 Global Alliance for Musculoskeletal Health, Bone and Joint Research, Knowledge Spa, Royal Cornwall Hospital, Truro, United Kingdom
  13. 13 Department of Epidemiology, School of Health, Bam University of Medical Sciences, Bam, Iran
  14. 14 Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
  15. 15 Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
  16. 16 Centre for Statistics in Medicine, NDORMS, Botnar Research Centre, University of Oxford, Oxford, UK
  17. 17 Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
  18. 18 Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
  19. 19 Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
  20. 20 Royal Cornwall Hospital and University of Exeter Medical School, Truro, United Kingdom
  21. 21 CIC 1433 Clinical Epidemiology,CHRU de Nancy, Inserm, Université de Lorraine, Nancy, France
  22. 22 Rheumatology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
  1. Correspondence to Dr Marita Cross, Institute of Bone and Joint Research, Faculty of Medicine and Health, The University of Sydney, Camperdown NSW 2006, Australia; marita.cross{at}


Objectives To report the level and trends of prevalence, incidence and years lived with disability (YLDs) for osteoarthritis (OA) in 195 countries and territories from 1990 to 2017 by age, sex and Socio-demographic index (SDI; a composite of sociodemographic factors).

Methods Publicly available modelled data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 were used. The burden of OA was estimated for 195 countries and territories from 1990 to 2017, through a systematic analysis of prevalence and incidence modelled data using the methods reported in the GBD 2017 Study. All estimates were presented as counts and age-standardised rates per 100 000 population, with uncertainty intervals (UIs).

Results Globally, the age-standardised point prevalence and annual incidence rate of OA in 2017 were 3754.2 (95% UI 3389.4 to 4187.6) and 181.2 (95% UI 162.6 to 202.4) per 100 000, an increase of 9.3% (95% UI 8% to 10.7%) and 8.2% (95% UI 7.1% to 9.4%) from 1990, respectively. In addition, global age-standardised YLD rate in 2017 was 118.8 (95% UI 59.5 to 236.2), an increase of 9.6% (95% UI 8.3% to 11.1%) from 1990. The global prevalence was higher in women and increased with age, peaking at the >95 age group among women and men in 2017. Generally, a positive association was found between the age-standardised YLD rate and SDI at the regional and national levels. Age-standardised prevalence of OA in 2017 ranged from 2090.3 to 6128.1 cases per 100 000 population. United States (6128.1 (95% UI 5729.3 to 6582.9)), American Samoa (5281 (95% UI 4688 to 5965.9)) and Kuwait (5234.6 (95% UI 4643.2 to 5953.6)) had the three highest levels of age-standardised prevalence. Oman (29.6% (95% UI 24.8% to 34.9%)), Equatorial Guinea (28.6% (95% UI 24.4% to 33.7%)) and the United States 23.2% (95% UI 16.4% to 30.5%)) showed the highest increase in the age-standardised prevalence during 1990–2017.

Conclusions OA is a major public health challenge. While there is remarkable international variation in the prevalence, incidence and YLDs due to OA, the burden is increasing in most countries. It is expected to continue with increased life expectancy and ageing of the global population. Improving population and policy maker awareness of risk factors, including overweight and injury, and the importance and benefits of management of OA, together with providing health services for an increasing number of people living with OA, are recommended for management of the future burden of this condition.

  • epidemiology
  • knee osteoarthritis
  • osteoarthritis

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Handling editor Josef S Smolen

  • Twitter @deepti_b

  • Contributors SS, AAK, LM and MC designed the study. SS, AAK, MAM, AA-H and AA-A analysed the data and performed the statistical analyses. SS, AAK, DB, ES, MS and MC drafted the initial manuscript. All authors reviewed the drafted manuscript for critical content. All authors approved the final version of the manuscript.

  • Funding The Global Burden of Disease study is funded by the Bill and Melinda Gates Foundation, which was not involved in any way in the preparation of this manuscript. This report was also supported by Shahid Beheshti University of Medical Sciences, Tehran, Iran (Grant No. 20607-4-7).

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by Ethics Committee of Shahid Beheshti University of Medical Sciences, Tehran, Iran (IR.SBMU.RETECH.REC.1398.414).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository. The data used for the analyses are publicly available from

  • Author note This study is based on publicly available data and solely reflects the opinion of its authors and not that of the Institute for Health Metrics and Evaluation.