Background/Purpose: Osteoarthritis (OA) is the most prevalent musculoskeletal condition, predominantly affecting individuals over the age of 55. According to the World Health Organization (WHO), OA has a global prevalence of 7.6%, with women comprising approximately 60% of cases. This study evaluates the global and U.S. trends in osteoarthritis incidence and prevalence from 1990 to 2021 using data from the Global Burden of Disease (GBD) study, highlighting the evolving burden on aging populations.

Methods: Data from the 2021 GBD database were analyzed to assess age-standardized incidence and prevalence rates of OA per 1,000,000 individuals aged 55 years and older. Trends from 1990 to 2021 were examined using the Annual Average Percentage Change (AAPC), with 95% confidence intervals (CIs) and p-values reported to determine statistical significance. Annual Percent Change (APC) was calculated across selected time intervals to capture fluctuations in trend patterns.

Results: Incidence: Globally, the incidence of OA increased significantly over the 31-year period, with an overall I-AAPC of 0.28% (95% CI: 0.26–0.30, p < 0.000001). Incidence rose by 0.286% in females and 0.28% in males, indicating similar upward trends across sexes. The global I-APC remained relatively stable, with no major deviations.In the United States, the I-AAPC was slightly lower at 0.20% (95% CI: 0.12–0.29, p < 0.000001). Males showed a lower rate of increase (0.16%) compared to females (0.28%), aligning closely with global female trends. However, APC varied significantly across intervals:1990–1995: Increase of 0.78% per year (95% CI: 0.49–0.94, p = 0.000002)1995–2005: Decline of -1.24% (95% CI: -1.32 to -1.15, p < 0.000001)2005–2009: Sharp increase of 1.84% (95% CI: 1.38–2.29, p < 0.000001)Prevalence: The global prevalence of OA also rose steadily, with a P-AAPC of 0.277% (95% CI: 0.26–0.27, p < 0.000001). Prevalence increased similarly among both males (0.28%) and females (0.29%). The most significant rise occurred between 2006–2009 with a P-APC of 0.69% (95% CI: 0.58–0.80, p < 0.000001), while the smallest change occurred between 2015–2018 (0.05%; 95% CI: -0.05 to 0.15, p = 0.315).In the United States, the P-AAPC was 0.1737% (95% CI: 0.0912–0.2563, p = 0.000037). Males showed a lower rate (0.14%) compared to females (0.24%). While overall prevalence increased, notable declines occurred:1995–1999: -1.46% (95% CI: -1.83 to -1.09, p < 0.000001)1999–2005: -0.89% The most significant rise occurred from 2005–2009, with a P-APC of 1.99%.

Conclusion: Between 1990 and 2021, both incidence and prevalence of osteoarthritis have increased among individuals aged 55 and older, in both the United States and globally. Despite some temporal fluctuations, the overall trend is upward, especially among women. These findings emphasize the growing burden of OA on aging populations and highlight the need for public health strategies focused on prevention, early diagnosis, and long-term management of osteoarthritis to reduce disability and healthcare costs associated with this chronic condition.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/incidence-and-prevalence-of-osteoarthritis-in-the-united-states-compared-to-global-trends-insights-from-the-global-burden-of-disease-study-1990-2021/