Deshpande Bhushan R, Katz Jeffrey N, Solomon Daniel H, Yelin Edward H, Hunter David J, Messier Stephen P, Suter Lisa G, Losina Elena
Brigham and Women's Hospital, Boston, Massachusetts.
Brigham and Women's Hospital, Harvard Medical School, and Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
Arthritis Care Res (Hoboken). 2016 Dec;68(12):1743-1750. doi: 10.1002/acr.22897. Epub 2016 Nov 3.
The prevalence of symptomatic knee osteoarthritis (OA) has been increasing over the past several decades in the US, concurrent with an aging population and the growing obesity epidemic. We quantify the impact of these factors on the number of persons with symptomatic knee OA in the early decades of the 21st century.
We calculated the prevalence of clinically diagnosed symptomatic knee OA from the National Health Interview Survey 2007-2008 and derived the proportion with advanced disease (defined as Kellgren/Lawrence grade 3 or 4) using the Osteoarthritis Policy Model, a validated simulation model of knee OA. Incorporating contemporary obesity rates and population estimates, we calculated the number of persons living with symptomatic knee OA.
We estimate that approximately 14 million persons had symptomatic knee OA, with advanced OA comprising more than half of those cases. This includes more than 3 million persons of racial/ethnic minorities (African American, Hispanic, and other). Adults younger than 45 years of age represented nearly 2 million cases of symptomatic knee OA and individuals between 45 and 65 years of age comprised 6 million more cases.
More than half of all persons with symptomatic knee OA are younger than 65 years of age. As many of these younger persons will live for 3 decades or more, there is substantially more time for greater disability to occur, and policymakers should anticipate health care utilization for knee OA to increase in the upcoming decades. These data emphasize the need for the deployment of innovative prevention and treatment strategies for knee OA, especially among younger persons.
在过去几十年中,美国有症状的膝关节骨关节炎(OA)患病率一直在上升,这与人口老龄化和肥胖症流行加剧同时出现。我们量化了这些因素对21世纪前几十年有症状的膝关节OA患者数量的影响。
我们根据2007 - 2008年国家健康访谈调查计算了临床诊断的有症状膝关节OA的患病率,并使用骨关节炎政策模型(一种经过验证的膝关节OA模拟模型)得出患有晚期疾病(定义为Kellgren/Lawrence 3级或4级)的比例。结合当代肥胖率和人口估计数,我们计算了有症状的膝关节OA患者的数量。
我们估计约有1400万人患有有症状的膝关节OA,其中晚期OA占这些病例的一半以上。这包括超过300万的少数族裔(非裔美国人、西班牙裔和其他族裔)。45岁以下的成年人中有近200万例有症状的膝关节OA病例,45至65岁的个体又增加了600万例。
所有有症状的膝关节OA患者中,超过一半年龄小于65岁。由于这些较年轻的人群中许多人将存活30年或更长时间,出现更大残疾的时间要长得多,政策制定者应预计在未来几十年中膝关节OA的医疗保健利用率会增加。这些数据强调需要为膝关节OA,特别是在较年轻人群中,部署创新的预防和治疗策略。