University of Sydney, Institute of Bone & Joint Research, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
University of Queensland, School of Population Health, Herston, Queensland, Australia.
Ann Rheum Dis. 2014 Jul;73(7):1323-30. doi: 10.1136/annrheumdis-2013-204763. Epub 2014 Feb 19.
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.
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).
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).
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.
作为 2010 年全球疾病负担研究的一部分，估算髋和膝关节骨关节炎（OA）的全球负担，并探讨髋和膝关节 OA 的负担与其他疾病的比较情况。
系统评价检索了髋和膝关节 OA 患病率、发病率和死亡率风险的年龄和性别特异性的流行病学数据。纳入了有症状、放射学和自我报告的髋或膝关节 OA 的患病率和发病率。定义了三个严重程度级别，以得出残疾权重（DWs）和严重程度分布（轻度、中度和重度 OA 的比例）。通过国家和地区的患病率乘以严重程度分布和适当的残疾权重，计算出患有残疾的生命年（YLDs）。由于没有直接归因于 OA 的死亡，因此 YLDs 等同于残疾调整生命年（DALYs）。
在全球范围内，在 291 种疾病中，髋和膝关节 OA 是导致全球残疾的第 11 大疾病，也是导致 DALYs 的第 38 大疾病。全球年龄标准化的膝关节 OA 患病率为 3.8%（95%不确定区间（UI）为 3.6%至 4.1%），髋关节 OA 为 0.85%（95% UI 为 0.74%至 1.02%），1990 年至 2010 年期间无明显变化。女性的患病率高于男性。髋和膝关节 OA 的 YLDs 从 1990 年的 1050 万（占总 DALYs 的 0.42%）增加到 2010 年的 1710 万（占总 DALYs 的 0.69%）。
髋和膝关节 OA 是全球残疾的主要原因之一。本研究中的方法学问题很可能导致 OA 的实际负担被低估。随着全球人口老龄化和肥胖率的增加，医疗保健专业人员需要为治疗髋和膝关节 OA 的卫生服务需求的大幅增加做好准备。
