Analysis of current status and trends of disease burden of knee osteoarthritis in China, 1990—2023_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIAO Jie , WU Gonghua , GUO Bing ,  ZHANG Juying ,  张菊英

Department of Epidemiology and Health Statistics, West China School of Public Health/West China Fourth Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China;

Corresponding author：

ZHANG Juying, Email: 249577872@qq.com; 张菊英, Email: 249577872@qq.com

Keywords：

Knee osteoarthritis; high body mass index; disease burden; trend analysis

DOI：

10.7507/1002-1892.202507100

Video：

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Objective To analyze the current status and trends of the disease burden of knee osteoarthritis (KOA) in China from 1990 to 2023, and to examine the epidemiological characteristics of age, gender differences, and attribution to high body mass index (BMI), in order to provide a basis for formulating prevention and treatment strategies to reduce the disease burden of knee KOA in China. Methods Based on the Global Burden of Disease (GBD) database, data on the number, rate, and age-standardized rate of incidence, prevalence, disability-adjusted life years (DALYs) for KOA, and DALYs for KOA attributable to high BMI in the Chinese population from 1990 to 2023 were integrated. The Joinpoint 5.4.0.0 software was used to analyze the age and gender differences in KOA and the epidemiological characteristics attributable to high BMI. Results The standardized incidence, prevalence, and DALYs rates of KOA in China in 2023 increased by 6.46%, 6.43%, and 6.93%, respectively, compared with 1990. In terms of age, the disease burden of KOA in China was lowest in the age group of 30-34 years, with the highest incidence rate in the age group of 50-54 years, whereas the prevalence rate and DALYs rate continued to increase with age, and both were highest in the age group of ≥70 years. In terms of gender, all disease burden standardized rate indicators were higher in women than in men, and the difference widened with age. The rate of BMI-attributable DALYs increased at an annual average rate of 1.57% (95%CI: 1.55, 1.59) from 1990 to 2023, again with significant age and gender differences. Conclusion The continued growth of the KOA disease burden and significant population differences characterizing China call for focused attention on the female middle-aged and elderly population, enhanced weight management, and implementation of targeted preventive and control measures.

1.	Pavel RMS, Purza AL, Tit DM, et al. Functional burden and quality of life in hip and knee osteoarthritis: A cross-sectional study. Medicina (Kaunas), 2025, 61(7): 1155. doi: 10.3390/medicina61071155.
2.	Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ, 2003, 81(9): 646-656.
3.	Hunter DJ, Schofield D, Callander E. The individual and socioeconomic impact of osteoarthritis. Nat Rev Rheumatol, 2014, 10(7): 437-441.
4.	Hall M, van der Esch M, Hinman RS, et al. How does hip osteoarthritis differ from knee osteoarthritis?. Osteoarthritis Cartilage, 2022, 30(1): 32-41.
5.	Sharma L. Osteoarthritis of the Knee. N Engl J Med, 2021, 384(1): 51-59.
6.	张莹莹, 李旭东, 杨佳娟, 等. 中国40岁及以上人群骨关节炎患病率的Meta分析. 中国循证医学杂志, 2021, 21(4): 407-414.
7.	冯晓晴, 蔡道章, 余星磊, 等. 基于GBD大数据中国膝骨关节炎疾病负担现状与趋势分析. 现代预防医学, 2022, 49(10): 1753-1760.
8.	Christensen R, Bartels EM, Astrup A, et al. Effect of weight reduction in obese patients diagnosed with knee osteoarthritis: a systematic review and meta-analysis. Ann Rheum Dis, 2007, 66(4): 433-439.
9.	Francisco V, Pérez T, Pino J, et al. Biomechanics, obesity, and osteoarthritis. The role of adipokines: When the levee breaks. J Orthop Res, 2018, 36(2): 594-604.
10.	GBD 2019 Diseases and Injuries Collaborators. 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(10258): 1204-1222.
11.	GBD 2021 Risk Factors Collaborators. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet, 2024, 403(10440): 2162-2203.
12.	曾四清. Joinpoint回归模型及其在传染病流行趋势分析中的应用. 中国卫生统计, 2019, 36(5): 787-791.
13.	中华中医药学会. 膝骨关节炎中西医结合诊疗指南 (2023年版). 中医正骨, 2023, 35(6): 1-10.
14.	Li M, Xia Q, Nie Q, et al. Burden of knee osteoarthritis in China and globally: 1990-2045. BMC Musculoskelet Disord, 2025, 26(1): 582. doi: 10.1186/s12891-025-08858-8.
15.	王斌, 邢丹, 董圣杰, 等. 中国膝骨关节炎流行病学和疾病负担的系统评价. 中国循证医学杂志, 2018, 18(2): 134-142.
16.	Miao Z, Li S, Luo Y, et al. Trends, inequalities and time-series based prediction of knee osteoarthritis attributed to high body-mass-index: findings from global burden of disease 2021. J Orthop Translat, 202, 52: 209-219.
17.	乔晓春. 中国人口老龄化的过去、现在和未来. 社会政策研究, 2024, 34(1): 47-63.
18.	国务院办公厅关于印发中国防治慢性病中长期规划 (201-72025年) 的通知. 中华人民共和国国务院公报, 2017, (7): 17-24.
19.	陈卫衡, 刘献祥, 童培建, 等. 膝骨关节炎中医诊疗专家共识(2015年版). 中医正骨, 2015, 27(07): 4-5.
20.	Luo Z, Lv H, Chen Y, et al. Years of life lost due to premature death and their trends in people with selected neurological disorders in Shanghai, China, 1995-2018: A population-based study. Front Neurol, 2021, 12: 625042. doi: 10.3389/fneur.2021.625042.
21.	Chen J, Chen X, Wang T, et al. Global burden of knee osteoarthritis from 1990 to 2021: Trends, inequalities, and projections to 2035. PLoS One, 2025, 20(6): e0320115. doi: 10.1371/journal.pone.0320115.
22.	Diekman BO, Loeser RF. Aging and the emerging role of cellular senescence in osteoarthritis. Osteoarthritis Cartilage, 2024, 32(4): 365-371.
23.	Li Y, Wei X, Zhou J, et al. The age-related changes in cartilage and osteoarthritis. Biomed Res Int, 2013, 2013: 916530. doi: 10.1155/2013/916530.
24.	Geraghty T, Obeidat AM, Ishihara S, et al. Age-associated changes in knee osteoarthritis, pain-related behaviors, and dorsal root ganglia immunophenotyping of male and female mice. Arthritis Rheumatol, 2023, 75(10): 1770-1780.
25.	Qu Y, Chen S, Han M, et al. Osteoporosis and osteoarthritis: a bi-directional Mendelian randomization study. Arthritis Res Ther, 2023, 25(1): 242. doi: 10.1186/s13075-023-03213-5.
26.	Eckstein F, Wirth W, Putz R. Sexual dimorphism in articular tissue anatomy - Key to understanding sex differences in osteoarthritis? Osteoarthritis Cartilage, 2024, 32(9): 1019-1031.
27.	Hernandez PA, Bradford JC, Brahmachary P, et al. Unraveling sex-specific risks of knee osteoarthritis before menopause: Do sex differences start early in life? Osteoarthritis Cartilage, 2024, 32(9): 1032-1044.
28.	王兵. 全球及中国的肥胖症流行病学现状及趋势. 中国普外基础与临床杂志, 2025, 32(06): 661-8.
29.	关于印发“体重管理年”活动实施方案的通知. 中华人民共和国国家卫生健康委员会公报, 2024, (6): 6-9.

1. Pavel RMS, Purza AL, Tit DM, et al. Functional burden and quality of life in hip and knee osteoarthritis: A cross-sectional study. Medicina (Kaunas), 2025, 61(7): 1155. doi: 10.3390/medicina61071155.
2. Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ, 2003, 81(9): 646-656.
3. Hunter DJ, Schofield D, Callander E. The individual and socioeconomic impact of osteoarthritis. Nat Rev Rheumatol, 2014, 10(7): 437-441.
4. Hall M, van der Esch M, Hinman RS, et al. How does hip osteoarthritis differ from knee osteoarthritis?. Osteoarthritis Cartilage, 2022, 30(1): 32-41.
5. Sharma L. Osteoarthritis of the Knee. N Engl J Med, 2021, 384(1): 51-59.
6. 张莹莹, 李旭东, 杨佳娟, 等. 中国40岁及以上人群骨关节炎患病率的Meta分析. 中国循证医学杂志, 2021, 21(4): 407-414.
7. 冯晓晴, 蔡道章, 余星磊, 等. 基于GBD大数据中国膝骨关节炎疾病负担现状与趋势分析. 现代预防医学, 2022, 49(10): 1753-1760.
8. Christensen R, Bartels EM, Astrup A, et al. Effect of weight reduction in obese patients diagnosed with knee osteoarthritis: a systematic review and meta-analysis. Ann Rheum Dis, 2007, 66(4): 433-439.
9. Francisco V, Pérez T, Pino J, et al. Biomechanics, obesity, and osteoarthritis. The role of adipokines: When the levee breaks. J Orthop Res, 2018, 36(2): 594-604.
10. GBD 2019 Diseases and Injuries Collaborators. 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(10258): 1204-1222.
11. GBD 2021 Risk Factors Collaborators. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet, 2024, 403(10440): 2162-2203.
12. 曾四清. Joinpoint回归模型及其在传染病流行趋势分析中的应用. 中国卫生统计, 2019, 36(5): 787-791.
13. 中华中医药学会. 膝骨关节炎中西医结合诊疗指南 (2023年版). 中医正骨, 2023, 35(6): 1-10.
14. Li M, Xia Q, Nie Q, et al. Burden of knee osteoarthritis in China and globally: 1990-2045. BMC Musculoskelet Disord, 2025, 26(1): 582. doi: 10.1186/s12891-025-08858-8.
15. 王斌, 邢丹, 董圣杰, 等. 中国膝骨关节炎流行病学和疾病负担的系统评价. 中国循证医学杂志, 2018, 18(2): 134-142.
16. Miao Z, Li S, Luo Y, et al. Trends, inequalities and time-series based prediction of knee osteoarthritis attributed to high body-mass-index: findings from global burden of disease 2021. J Orthop Translat, 202, 52: 209-219.
17. 乔晓春. 中国人口老龄化的过去、现在和未来. 社会政策研究, 2024, 34(1): 47-63.
18. 国务院办公厅关于印发中国防治慢性病中长期规划 (201-72025年) 的通知. 中华人民共和国国务院公报, 2017, (7): 17-24.
19. 陈卫衡, 刘献祥, 童培建, 等. 膝骨关节炎中医诊疗专家共识(2015年版). 中医正骨, 2015, 27(07): 4-5.
20. Luo Z, Lv H, Chen Y, et al. Years of life lost due to premature death and their trends in people with selected neurological disorders in Shanghai, China, 1995-2018: A population-based study. Front Neurol, 2021, 12: 625042. doi: 10.3389/fneur.2021.625042.
21. Chen J, Chen X, Wang T, et al. Global burden of knee osteoarthritis from 1990 to 2021: Trends, inequalities, and projections to 2035. PLoS One, 2025, 20(6): e0320115. doi: 10.1371/journal.pone.0320115.
22. Diekman BO, Loeser RF. Aging and the emerging role of cellular senescence in osteoarthritis. Osteoarthritis Cartilage, 2024, 32(4): 365-371.
23. Li Y, Wei X, Zhou J, et al. The age-related changes in cartilage and osteoarthritis. Biomed Res Int, 2013, 2013: 916530. doi: 10.1155/2013/916530.
24. Geraghty T, Obeidat AM, Ishihara S, et al. Age-associated changes in knee osteoarthritis, pain-related behaviors, and dorsal root ganglia immunophenotyping of male and female mice. Arthritis Rheumatol, 2023, 75(10): 1770-1780.
25. Qu Y, Chen S, Han M, et al. Osteoporosis and osteoarthritis: a bi-directional Mendelian randomization study. Arthritis Res Ther, 2023, 25(1): 242. doi: 10.1186/s13075-023-03213-5.
26. Eckstein F, Wirth W, Putz R. Sexual dimorphism in articular tissue anatomy - Key to understanding sex differences in osteoarthritis? Osteoarthritis Cartilage, 2024, 32(9): 1019-1031.
27. Hernandez PA, Bradford JC, Brahmachary P, et al. Unraveling sex-specific risks of knee osteoarthritis before menopause: Do sex differences start early in life? Osteoarthritis Cartilage, 2024, 32(9): 1032-1044.
28. 王兵. 全球及中国的肥胖症流行病学现状及趋势. 中国普外基础与临床杂志, 2025, 32(06): 661-8.
29. 关于印发“体重管理年”活动实施方案的通知. 中华人民共和国国家卫生健康委员会公报, 2024, (6): 6-9.

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