Abstract
Background
Understanding population‐level trends in osteoarthritis (OA) is critical for planning health services and disease prevention initiatives.
Aim
To examine trends in the burden of hip, knee, hand and other OA related conditions in Australia from 1990 to 2019 and consider the OA burden in the context of other common conditions associated with older age.
Methods
Global Burden of Disease Study 2019 data for Australia on OA prevalence, OA‐related years lived with disability (YLDs) and OA‐related YLDs attributable to high body mass index (BMI) were sourced for 1990–2019. Age‐standardised YLD data for ischaemic heart disease, stroke, dementia, type 2 diabetes and chronic obstructive pulmonary disease were obtained for comparison.
Results
Overall, 3.20 million Australians were estimated to have OA in 2019, with substantial growth in the prevalence of hip (+171%), knee (+126%), hand (+110%) and other types of OA (+130%) from 1990 to 2019. Age‐standardised prevalence rates reflect the contribution of population ageing. Concomitant growth in OA‐related YLDs was also evident; knee OA and hand OA demonstrated the highest disease burden in 2019 (59 684 and 41 893 YLDs respectively). The proportion of knee OA burden attributable to high BMI was 36% in 2019. In 2019, age‐standardised YLD rates were higher for OA (313 per 100 000 population) than other common conditions (range: 47 per 100 000 (ischaemic heart disease) to 284 per 100 000 (type 2 diabetes)).
Conclusions
OA is an increasingly prevalent, impactful condition with a high non‐fatal disease burden relative to other health conditions. Growth in OA populations and OA‐related disability underscore the need for enhanced investment in prevention and management.
Keywords: disease burden, Global Burden of Disease, hand, hip, knee, osteoarthritis
Introduction
Osteoarthritis (OA) is the most common form of arthritis and has been estimated to affect over 2.2 million Australians. 1 While mild to moderate forms of the condition can be managed via non‐surgical means (e.g. with guideline‐recommended education, exercise, weight management and pharmacological treatments 2 ), more severe OA may require joint replacement surgery. Over 125 000 joint replacements are undertaken in Australia each year, with the majority performed for severe OA. 3 The healthcare costs of managing OA in Australia are substantial, exceeding $3.9 billion annually. 4 While pain, stiffness and reduced mobility are frequent impairments, the broader quality of life and psychosocial impacts of OA are also well known. 5 , 6 OA has traditionally been considered a degenerative disease of older age, but newer evidence also points to the impacts on younger people, who are at heightened risk of developing OA after joint injury. 7
Understanding population‐level trends in the burden of diseases such as OA is critical not only for health service development and health workforce planning but also for signalling a need for new public health programs and enhanced investment in prevention initiatives. The well‐established Global Burden of Disease Study provides a valuable opportunity to examine such trends. Led by the Institute for Health Metrics and Evaluation in the United States, the Global Burden of Disease Study is supported by a large collaborator network worldwide. Since 1990, the study has modelled international data on disease prevalence and premature death and disability due to disease, with regular disease burden updates published as new epidemiological data emerge. In the latest 2019 iteration, data are available for more than 369 diseases and injuries in 204 countries. 8 A key finding has been the growing prominence of non‐communicable diseases that are highly prevalent and associated with substantial morbidity. In 2019, OA was ranked the 18th leading cause of global disability for people aged 50–74 years – up from 24th in 1990, with a 114% increase in disability burden over this period. 8 In the absence of empirical OA data for Australia that are joint‐specific, Global Burden of Disease Study data allow us to describe national‐level OA disease burden for the most commonly affected joints (hip, knee and hand) as well as ‘other’ joints, to inform future health policy planning and service provision.
This study aimed to examine changes in the prevalence of hip, knee, hand and other OA in Australia from 1990 to 2019 and changes in disease burden, expressed as years lived with disability (YLDs) and age‐standardised YLD rates. An additional aim was to consider OA disease burden within the context of other health conditions that are commonly associated with older age (ischaemic heart disease, stroke, dementia, type 2 diabetes and chronic obstructive pulmonary disease) and have common risk factors.
Methods
Study design
Descriptive analysis of Global Burden of Disease Study 1990–2019 data for Australia.
Ethics approval
Not required as only publicly available data were used.
Data source
This study used available data from the Global Burden of Disease Study, obtained from the online Global Burden of Disease Results Tool (http://ghdx.healthdata.org/gbd-results-tool). Since a detailed description of Global Burden of Disease Study methods has been published elsewhere, 8 only a brief overview is provided here. Input data for the Global Burden of Disease Study are drawn from multiple sources, including national censuses, public surveys, disease registries, claims data, published epidemiological studies and systematic reviews. 8 For countries such as Australia where sparse national epidemiological data are available, a Bayesian meta‐regression tool (DISMOD‐MR) is used to model disease prevalence, based on available international data inputs and available covariate data. Prevalence estimates are multiplied by disability weights and severity distributions to calculate YLDs for a given cause of disease. Published disability weights and severity distributions for hip and knee OA 9 were also applied to hand OA and other OA modelling. A list of data sources for Australia, including data sources for population size and structure, one primary study on hand OA, data sources for high body mass index (BMI) and data sources for covariates, can be found on the Global Health Data Exchange. 10
For the present study, modelled Australian data for the following Global Burden of Disease Study causes were extracted: hip OA, knee OA, hand OA, other OA, all OA, stroke, type 2 diabetes, ischaemic heart disease, chronic obstructive pulmonary disease and Alzheimer's disease and other dementias. Global Burden of Disease Study case definitions for these causes can be found in Table S1. Hand OA was included as a new cause of disease in the 2019 Global Burden of Disease study, comprising any single hand joint. 11 The published methods for modelling hand OA refer to the use of meta‐regression for data that reported on different subsets and combinations of hand joints, with adjustments made to studies reporting hand OA in multiple joint types identified by pain alone, radiography alone or clinical evaluation without the use of radiography. Other OA was also included as a new cause in 2019 and was defined as OA in any joint other than the hip, knee, hand or spine. 11
For the present study, the specific metrics of interest included prevalence (reported as counts and rates per 100 000 population) and YLDs (reported as counts and age‐standardised rates per 100 000 population). While disability‐adjusted life year data are also available, YLDs are useful for comparing non‐fatal disease burden between different health conditions because they do not incorporate a mortality component in their calculation. Although there are additional known risk factors for the development of OA, high BMI is the only risk factor considered by the Global Burden of Disease Study in relation to hip OA and knee OA. Data on the number and proportion of YLDs for hip OA and knee OA attributable to high BMI were also extracted for analysis. The Global Burden of Disease Study reports uncertainty intervals (UIs) around their point estimates; the UIs are obtained from bootstrapping methods and are based on the 2.5th and 97.5th percentiles. 8
Data analysis
Prevalence and YLD data for 1990–2019 were analysed descriptively to examine joint‐specific and sex‐specific trends in OA disease burden. Changes over time in the number and proportion of YLDs for hip OA and knee OA attributable to high BMI were also examined descriptively. A subgroup analysis restricted to younger individuals (those aged 25–49 years) was also undertaken. Total YLDs in 1990 and 2019 and age‐standardised YLD rates for OA in 2019 were compared descriptively to YLD data for stroke, type 2 diabetes, ischaemic heart disease, chronic obstructive pulmonary disease, Alzheimer's disease and other dementias.
Results
Joint‐specific prevalence of OA in Australia
Overall, 3.20 million Australians were estimated to have OA in 2019, up from 1.46 million in 1990 (118% increase). Specifically, 299 101 cases of hip OA (171% increase from 1990), 1 904 137 cases of knee OA (126% increase), 1 339 641 cases of hand OA (110% increase) and 311 065 cases of other OA (130% increase) in Australia were estimated in 2019.
Age‐standardised prevalence rates, by joint and sex, are reported in Table 1. Among Australian females, the prevalence of hip OA, knee OA, hand OA and other OA increased substantially from 1990 to 2019. As shown in Figure 1, knee OA remained the most prevalent form of OA for females over the study period. In 2019, knee OA was estimated to affect 1 159 216 females, representing a 120% increase from 1990 numbers. Hand OA was the next most prevalent condition among females, with a 110% increase from 1990 to 2019 (from 498 226 to 1 045 789 cases). Other OA increased by 124% among females, from 74 000 cases in 1990 to 165 554 cases in 2019. Hip OA was the least common OA condition, estimated to affect 60 103 females in 1990 and 158 415 females in 2019 (164% increase).
Table 1.
Age‐standardised prevalence rates, by joint and sex
| Age‐standardised prevalence rate† (UI) | ||
|---|---|---|
| 1990 | 2019 | |
| Hip osteoarthritis | ||
| Females | 570 (433–722) | 755 (577–961) |
| Males | 564 (431–716) | 763 (577–967) |
| Knee osteoarthritis | ||
| Females | 5107 (4401–5895) | 5731 (4941–6547) |
| Males | 3551 (3006–4132) | 4062 (3489–4702) |
| Hand osteoarthritis | ||
| Females | 4915 (3671–6497) | 5199 (3893–6949) |
| Males | 1588 (1183–2123) | 1588 (1183–2123) |
| Other osteoarthritis | ||
| Females | 706 (539–897) | 788 (589–1005) |
| Males | 703 (533–899) | 782 (595–968) |
Cases per 100 000 population.
UI, uncertainty interval.
Figure 1.
Prevalence of osteoarthritis among Australian females from 1990 to 2019, by joint. (
) Hip OA, (
) Knee OA, (
) Hand OA and (
) Other OA.
Although OA was less prevalent among males, compared to females, there was substantial growth in the prevalence of hip OA, knee OA, hand OA and other OA in males over the study period. Similar to females, knee OA was the most common form of OA for males. In 2019, knee OA was estimated to affect 744 921 males, representing an increase of 135% from 1990 estimates. Hand OA was the next most prevalent form of OA, with a 109% increase from 1990 to 2019 (from 140 481 to 293 852 cases). The prevalence of hip OA and other OA among males also increased over time (by 181% and 137%, respectively), although these conditions remained less common than knee OA and hand OA (Fig. 2).
Figure 2.
Prevalence of osteoarthritis among Australian males from 1990 to 2019, by joint. (
) Hip OA, (
) Knee OA, (
) Hand OA and (
) Other OA.
For both sexes, increasing age was associated with higher prevalence rates for hip OA, knee OA, hand OA and other OA (Tables S2 and S3).
YLDs due to hip, knee, hand and other OA
As shown in Table 2, knee OA was associated with the highest number of YLDs in 2019 (36 244 YLDs for females and 23 440 for males), followed by hand OA (32 696 YLDs for females and 9197 for males). In contrast, YLDs for hip OA and other OA were relatively low (Table 2). The number of YLDs for hip, knee, hand and other OA more than doubled from 1990 to 2019 for females and males. The greatest growth in disability burden was seen for hip OA, with an increase in YLDs of 163% for females and 179% for males. In 2019, 12.2% of YLDs for hip OA were attributed to high BMI, up from 9.1% in 1990. In 2019, 35.6% of YLDs for knee OA were attributed to high BMI, up from 27.5% in 1990. Age‐standardised data demonstrated a smaller increase in YLD rates over time for hip OA, knee OA and other OA, whereas there was little or no change in age‐standardised YLD rates for hand OA (Table 3).
Table 2.
Changes in years lived with disability from 1990 to 2019, by joint and sex
| Number of years lived with disability (UI) | |||
|---|---|---|---|
| 1990 | 2019 | Change from 1990 | |
| Hip osteoarthritis | |||
| Females | 1874 (877–3923) | 4923 (2375–9957) | +163% |
| Males | 1583 (743–3330) | 4410 (2103–9095) | +179% |
| Knee osteoarthritis | |||
| Females | 16 501 (8334–33 572) | 36 244 (17 921–73 337) | +120% |
| Males | 10 012 (4989–20 528) | 23 440 (11 782–47 779) | +134% |
| Hand osteoarthritis | |||
| Females | 15 611 (7791–32 954) | 32 696 (16 384–68 627) | +109% |
| Males | 4430 (2165–9408) | 9197 (4492–19 344) | +108% |
| Other osteoarthritis | |||
| Females | 2297 (1139–4683) | 5118 (2581–10 703) | +123% |
| Males | 1922 (939–3960) | 4539 (2291–9283) | +136% |
UI, uncertainty interval.
Table 3.
Changes in age‐standardised rates of years lived with disability, by joint and sex
| Age‐standardised years lived with disability rate† (UI) | |||
|---|---|---|---|
| 1990 | 2019 | Change from 1990 | |
| Hip osteoarthritis | |||
| Females | 17.84 (8.33–37.33) | 23.67 (11.36–48.14) | +33% |
| Males | 17.78 (8.33–37.36) | 24.04 (11.35–49.27) | +35% |
| Knee osteoarthritis | |||
| Females | 160.71 (81.02–327.81) | 180.41 (89.01–365.29) | +12% |
| Males | 112.08 (56.12–230.85) | 128.43 (64.19–261.82) | +15% |
| Hand osteoarthritis | |||
| Females | 154.61 (77.44–325.82) | 163.76 (82.20–339.31) | +6% |
| Males | 49.93 (24.44–105.85) | 49.93 (24.20–104.95) | 0% |
| Other osteoarthritis | |||
| Females | 22.01 (10.84–44.91) | 24.58 (12.27–50.86) | +12% |
| Males | 21.94 (10.72–45.32) | 24.50 (12.31–49.96) | +12% |
Years lived with disability per 100 000 population.
UI, uncertainty interval.
OA burden among younger adults in Australia
The prevalence of OA among younger adults aged 20–49 years was 3335 per 100 000 population in 1990, rising to 4147 per 100 000 population in 2019 (24% increase). In total, 353 373 younger Australians were estimated to have OA in 2019. The number of OA‐related YLDs for this age group increased by 70% over the study period, from 7136 in 1990 to 12 144 in 2019. Among this age group, 8.9% of YLDs for hip OA were attributed to high BMI in 1990 and this increased to 12.6% in 2019. The proportion of YLDs for knee OA attributable to high BMI increased from 27.3% in 1990 to 37.0% in 2019 among adults aged 20–49 years.
Comparison of YLDs due to other health conditions
Table 4 presents YLDs for OA in Australia, in comparison to YLDs for other common health conditions associated with older age. For all these conditions, including OA, the number of YLDs increased from 1990 to 2019. In 2019, YLDs for OA totalled 120 567 (UI 60 987–242 883), exceeding YLD estimates for type 2 diabetes, chronic obstructive pulmonary disease, Alzheimer's disease and other dementias, stroke and ischaemic heart disease. When examining age‐standardised metrics, OA demonstrated the highest YLD rates at 313 YLDs per 100 000 population, followed by type 2 diabetes (284 YLDs per 100 000 population). Ischaemic heart disease had the lowest YLD rate (47 YLDs per 100 000 population).
Table 4.
Comparison of years lived with disability for common health conditions
| Number of years lived with disability (UI) | ||||
|---|---|---|---|---|
| Health condition | 1990 | 2019 | Change | Age‐standardised rate‡ (UI) in 2019 |
| Osteoarthritis† | 54 231 (27 543–108 244) | 120 567 (60 987–242 883) | +122% | 313 (158–634) |
| Type 2 diabetes | 32 895 (21 936–46 291) | 110 395 (72 234–154 572) | +236% | 284 (186–402) |
| Chronic obstructive pulmonary disease | 43 201 (34 078–50 744) | 81 305 (64 648–95 288) | +88% | 201 (160–236) |
| Alzheimer disease and other dementias | 17 912 (12 618–24 051) | 46 381 (32 545–62 025) | +159% | 97 (68–129) |
| Stroke | 27 820 (20 138–35 147) | 38 558 (28 180–48 926) | +39% | 103 (75–131) |
| Ischaemic heart disease | 15 970 (10 634–22 877) | 20 700 (13 781–29 718) | +30% | 47 (31–68) |
Includes hip, knee, hand and other osteoarthritis.
Years lived with disability per 100 000 population.
UI, uncertainty interval.
Discussion
This study highlights the growing disease burden of OA in Australia over three decades, drawing on national‐level modelled data from the longstanding Global Burden of Disease Study. Hand OA was recently included as a separate cause of disease, enabling us to examine prevalence and disability data for three bodily sites most commonly affected by OA. Taken together, these data provide a strong impetus for investment in OA primary prevention programs (e.g. prevention of injuries and prevention of weight gain) and strategies to reduce disability‐related burden. These national data also highlight pronounced health inequities for females, who demonstrate higher population rates of hip, knee and hand OA as well as greater disability due to these conditions. While age‐standardised rates suggest that much of the observed increase in prevalence stems from population ageing, the sheer number of Australians estimated to be living with OA (3.20 million) who may require care for this condition over their lifetime is undoubtedly an important metric for our health system.
The Global Burden of Disease Study data reveal a previously unrecognised burden of hand OA in Australia that is second in magnitude only to knee OA. In particular, the prevalence rate of hand OA was two to three times higher for females than for similarly‐aged males. While dedicated programs for the management of hip and knee OA are available (e.g. the Osteoarthritis Chronic Care Program in New South Wales and the Osteoarthritis Hip and Knee Service in Victoria), we are not aware of targeted clinical services for hand OA. Similarly, contemporary Australian clinical care standards, 12 international clinical guidelines 2 and local models of care all focus on lower limb OA. A PubMed search also reveals clear discrepancies in research volume according to the affected joint, with >6000 papers pertaining to hand OA versus >21 000 and > 45 000 papers pertaining to hip OA and knee OA respectively. It is apparent that more needs to be done to support evidence‐based clinical care for people with hand OA.
OA is known to be a substantial contributor to the global burden of disease for people aged 50 years and over. 8 These data confirm the population‐level burden of OA in the context of other common health conditions that impact older Australians. Whether expressed as total YLDs or age‐standardised YLD rates, we found that the disability burden due to OA was high when considered relative to that of type 2 diabetes, chronic obstructive pulmonary disease, Alzheimer's disease and other dementias, stroke and ischaemic heart disease. Of note is that for all these diseases, the disability burden increased from 1990 to 2019. While OA prevention and management are not often considered within a multimorbidity paradigm, there is overlap in the risk factors for OA and other chronic health conditions (e.g. obesity and low physical activity). Public health interventions that target physical activity, exercise and weight loss could therefore have broader population impacts that extend beyond OA. 13 , 14 While some of the observed increase since 1990 in YLDs due to OA likely reflects an increasing number of older Australians, the growth in age‐standardised YLD rates from 1990 to 2019 for hip OA (both sexes), knee OA (both sexes), hand OA (females only) and other OA (both sexes) shows that the increasing disability burden is not solely related to population ageing. Another important finding is the increasing burden of OA among adults aged 20–49 years in Australia. While OA was previously considered uncommon among younger adults, the impacts of the condition on people of working age are increasingly recognised. 7 Given the sizeable number of younger people affected (>353 000 Australians, based on an OA prevalence of 4.1% in 2019), preventing OA progression at this critical life stage could have a significant impact on future need for joint replacement in Australia.
Our understanding of the changing burden of OA in Australia has largely been limited to indicators of rising surgical demand for OA, such as the increasing use of hip and knee replacement. 3 , 15 , 16 The National Health Survey is usually conducted every 3 years (most recently in 2017–2018 1 ) and provides cross‐sectional data on OA prevalence (a new study sample is recruited for each iteration); however, these data are not joint‐specific. The recent Australian Burden of Disease Study findings also relied on National Health Survey data for overall OA prevalence. 17 Other information on OA burden in Australia has come from modelling studies based on the National Health Survey 18 or from smaller national or state‐based cohorts. 19 , 20 Understanding factors that have contributed to the observed rise in OA burden is challenging based on the available data. Alongside the ageing population, other contributing factors likely include an increasing national prevalence of overweight and obesity as well as rising rates of sports injuries. 21 However, high BMI is the only risk factor to be considered within the of Disease Study with respect to hip and knee OA. The increasing burden of hip and knee OA that can be attributed to high BMI aligns with reported growth in population‐level overweight and obesity in Australia (from 56% in 1995 to 67% in 2017/2018 22 ). Current evidence indicates that high BMI adversely affects joints not only via greater joint loading but also via the pro‐inflammatory effects of body fat. 23
A key strength of this study was the ability to report separate disease burden estimates for hip, knee and hand OA, with consideration of both crude and age‐standardised metrics. We also provided a broader context for the OA‐related YLD estimates by reporting age‐standardised comparisons with other prevalent health conditions impacting older individuals. Additionally, we acknowledge the study's limitations. As acknowledged previously, 24 , 25 in many countries there is a paucity of population‐level, representative data to enable us to understand changes over time in the burden of conditions such as OA. Modelled burden of disease data offer an accessible approach in this regard. Where sufficient primary epidemiological data are not available, the Global Burden of Disease Study uses well‐documented modelling methods, including the use of available covariate data for each country, to generate prevalence and other disease burden estimates. Notwithstanding the comprehensive analytic approach, we recognise there are known limitations with respect to source data coverage, 26 and we acknowledge the wide UIs around the OA point estimates. Boosting primary data collection is key to improving the accuracy of Global Burden of Disease Study estimates 8 ; in Australia this could be achieved by adding hip‐, knee‐ and hand‐specific OA to the data collection procedures for future National Health Surveys. Based on the available data, we are unable to comment on the proportion of bilateral versus unilateral OA or on specific hand or other bodily joints affected. Because lumbar spine OA is included in the ‘low back pain’ cause of disease in the Global Burden of Disease Study, this could not be specifically examined. Finally, we acknowledge that the societal burden of OA also includes participation and work productivity impairments that are not currently considered within Global Burden of Disease Study metrics but could be estimated using newly developed metrics. 27
Conclusion
This study identified substantial growth over three decades in the size of Australian hip, knee, hand and other OA populations and in OA‐related YLDs, particularly for females and most notably for the knee and hand. Changes in age‐standardised prevalence and YLD rates indicate that much of this growth relates to population ageing. The proportion of disease burden attributable to high BMI also increased over time for hip and knee OA. These Global Burden of Disease Study data confirm that OA is a highly prevalent and disabling condition which has a high non‐fatal disease burden when examined in the context of other common health conditions associated with older age. Enhanced investment in primary prevention and effective OA management must become a high priority, given the mounting disease burden.
Supporting information
Table S1. Global Burden of Disease Study cause of disease definitions
Table S2. Prevalence of hip and knee osteoarthritis in Australia by age and sex in 1990 and 2019
Table S3. Prevalence of hand and other osteoarthritis in Australia by age and sex in 1990 and 2019
Acknowledgements
The authors wish to thank the Institute for Health Metrics and Evaluation (IHME) for preparing the Global Burden of Disease data. This study is based on publicly available data and solely reflects the views of the authors and not of the IHME. Professor Ackerman is supported by a Monash University Faculty of Medicine, Nursing and Health Sciences Senior Postdoctoral Fellowship. Professor Buchbinder is supported by an Australian National Health and Medical Research Council Investigator Grant (APP1194482). Open access publishing facilitated by Monash University, as part of the Wiley ‐ Monash University agreement via the Council of Australian University Librarians.
Funding: Monash University, National Health and Medical Research Council: APP1194482.
References
- 1. Australian Bureau of Statistics . 4364.0.55.001 – National Health Survey: First Results, 2017–18. Available from URL: https://www.abs.gov.au/statistics/health/health-conditions-and-risks/national-health-survey-first-results/latest-release
- 2. Royal Australian College of General Practitioners . Guideline for the Management of Knee and Hip Osteoarthritis, 2nd edn. East Melbourne: Royal Australian College of General Practitioners; 2018. [Google Scholar]
- 3. Australian Orthopaedic Association National Joint Replacement Registry . Annual Report – Hip, Knee and Shoulder Arthroplasty. Adelaide: Australian Orthopaedic Association; 2020. [Google Scholar]
- 4. Australian Institute of Health and Welfare . Disease Expenditure in Australia. Available from URL: https://www.aihw.gov.au/reports/health-welfare-expenditure/disease-expenditure-australia/contents/summary
- 5. Salaffi F, Carotti M, Stancati A, Grassi W. Health‐related quality of life in older adults with symptomatic hip and knee osteoarthritis: a comparison with matched healthy controls. Aging Clin Exp Res 2005; 17: 255–63. [DOI] [PubMed] [Google Scholar]
- 6. Furner SE, Hootman JM, Helmick CG, Bolen J, Zack MM. Health‐related quality of life of US adults with arthritis: analysis of data from the behavioral risk factor surveillance system, 2003, 2005, and 2007. Arthritis Care Res 2011; 63: 788–99. [DOI] [PubMed] [Google Scholar]
- 7. Ackerman IN, Kemp JL, Crossley KM, Culvenor AG, Hinman RS. Hip and knee osteoarthritis affects younger people, too. J Orthop Sports Phys Ther 2017; 47: 67–79. [DOI] [PubMed] [Google Scholar]
- 8. Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990‐2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396: 1204–22. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9. Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M et al. The global burden of hip and knee osteoarthritis: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis 2014; 73: 1323–30. [DOI] [PubMed] [Google Scholar]
- 10. Institute for Health Metrics and Evaluation . Global Health Data Exchange. Available from URL: http://ghdx.healthdata.org/
- 11. Institute for Health Metrics and Evaluation . Global Burden of Disease 2019 Disease, Injury, and Impairment Summaries. Available from URL: http://www.healthdata.org/results/gbd_summaries/2019
- 12. Australian Commission on Safety and Quality in Health Care . Clinical Care Standards – Osteoarthritis of the Knee. Sydney: Australian Commission on Safety and Quality in Health Care. [Google Scholar]
- 13. Skou ST, Pedersen BK, Abbott JH, Patterson B, Barton C. Physical activity and exercise therapy benefit more than just symptoms and impairments in people with hip and knee osteoarthritis. J Orthop Sports Phys Ther 2018; 48: 439–47. [DOI] [PubMed] [Google Scholar]
- 14. Haase CL, Lopes S, Olsen AH, Satylganova A, Schnecke V, McEwan P. Weight loss and risk reduction of obesity‐related outcomes in 0.5 million people: evidence from a UK primary care database. Int J Obes 2021; 45: 1249–58. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15. Ackerman IN, Bohensky MA, De Steiger R, Brand CA, Eskelinen A, Fenstad AM et al. Substantial rise in the lifetime risk of primary total knee replacement surgery for osteoarthritis from 2003‐2013: an international, population‐level analysis. Osteoarthr Cartil 2017; 25: 455–61. [DOI] [PubMed] [Google Scholar]
- 16. Ackerman IN, Bohensky MA, de Steiger R, Brand CA, Eskelinen A, Fenstad AM et al. Lifetime risk of primary total hip replacement surgery for osteoarthritis from 2003‐2013: a multi‐national analysis using national registry data. Arthritis Care Res 2017; 69: 1659–67. [DOI] [PubMed] [Google Scholar]
- 17. Australian institute of Health and Welfare . Australian Burden of Disease Study 2015: Interactive Data on Disease Burden. Available from URL: https://www.aihw.gov.au/reports/burden-of-disease/abds-2015-interactive-data-disease-burden/data
- 18. Ackerman IN, Pratt C, Gorelik A, Liew D. Projected burden of osteoarthritis and rheumatoid arthritis in Australia: A population‐level analysis. Arthritis Care Res 2018; 70: 877–83. [DOI] [PubMed] [Google Scholar]
- 19. Szoeke CEI, Cicuttini FM, Guthrie JR, Clark MS, Dennerstein L. Factors affecting the prevalence of osteoarthritis in healthy middle‐aged women: data from the longitudinal Melbourne Women's Midlife Health Project. Bone 2006; 39: 1149–55. [DOI] [PubMed] [Google Scholar]
- 20. Ackerman IN, Osborne RH. Obesity and increased burden of hip and knee joint disease in Australia: results from a national survey. BMC Musculoskelet Disord 2012; 13: 1–13. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21. Finch CF, Kemp JL, Clapperton AJ. The incidence and burden of hospital‐treated sports‐related injury in people aged 15+years in Victoria, Australia, 2004‐2010: a future epidemic of osteoarthritis? Osteoarthr Cartil 2015; 23: 1138–43. [DOI] [PubMed] [Google Scholar]
- 22. Australian Institute of Health and Welfare . Overweight and Obesity: an Interactive Insight. Available from URL: https://www.aihw.gov.au/reports/overweight-obesity/overweight-and-obesity-an-interactive-insight/data
- 23. Cicuttini F, Wluka A. Not just loading and age: the dynamics of osteoarthritis, obesity and inflammation. Med J Aust 2016; 204: 47. [DOI] [PubMed] [Google Scholar]
- 24. de Luca K, Briggs AM, French SD, Ferreira ML, Cross M, Blyth F et al. Disability burden due to musculoskeletal conditions and low back pain in Australia: findings from GBD 2019. Chiropr Man Therap 2022; 30: 22. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 25. Singh A, Das S, Chopra A, Danda D, Paul BJ, March L et al. Burden of osteoarthritis in India and its states, 1990‐2019: findings from the Global Burden of Disease Study 2019. Osteoarthr Cartil 2022; 30: 1070–8. [DOI] [PubMed] [Google Scholar]
- 26. Tamrakar M, Kharel P, Traeger A, Maher C, O'Keeffe M, Ferreira G. Completeness and quality of low back pain prevalence data in the Global Burden of Disease Study 2017. BMJ Glob Health 2021; 6: e005847. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 27. Ademi Z, Ackerman IN, Zomer E, Liew D. Productivity‐adjusted life‐years: a new metric for quantifying disease burden. Pharmacoeconomics 2021; 39: 271–3. [DOI] [PMC free article] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Table S1. Global Burden of Disease Study cause of disease definitions
Table S2. Prevalence of hip and knee osteoarthritis in Australia by age and sex in 1990 and 2019
Table S3. Prevalence of hand and other osteoarthritis in Australia by age and sex in 1990 and 2019