Skip to main content

Advertisement

Log in

Epidemiology of osteoarthritis: An update

  • Published:
Current Rheumatology Reports Aims and scope Submit manuscript

Abstract

Osteoarthritis is the most common form of arthritis and is a leading cause of disability in the elderly. Given the anticipated increase in osteoarthritis prevalence, the need to identify risk factors for incident osteoarthritis, osteoarthritis progression, osteoarthritis-associated physical function decline, and disability is an especially high priority. Findings have implicated several factors, including genetic factors, aging, joint deformity and injury, obesity, and hormonal deficiencies in the pathogenesis of osteoarthritis. Recent studies have identified risk factors associated with progression of the disease including varus-valgus alignment, bone marrow edema lesions, varus thrust, a reduced hip abduction moment, and obesity. Predictors of function decline in osteoarthritis include lower self-efficacy, knee laxity, less aerobic exercise, worse joint proprioception, and greater knee pain.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Lawrence R, Helmick C, Arnett F, et al.: Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum 1998, 41:778–799.

    Article  PubMed  CAS  Google Scholar 

  2. Kellgren JH, Lawrence JS: Atlas of Standard Radiographs, Department of Rheumatology and Medical Illustrations, University of Manchester. Oxford: Blackwell; 1963.

    Google Scholar 

  3. Felson DT, Zhang Y, Hannan MT, et al.: The incidence and natural histor y of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum 1995, 38:1500–1505.

    Article  PubMed  CAS  Google Scholar 

  4. Oliveria SA, Felson DT, Reed JI, et al.: Incident of symptomatic hand, hip and knee osteoarthritis among patients in a health maintenance organization. Arthritis Rheum 1995, 38:1134–1141.

    Article  PubMed  CAS  Google Scholar 

  5. Wilson MG, Michet CJ Jr, Ilstrup DM, et al.: Idiopathic symptomatic osteoarthritis of the hip and knee: a population-based incidence study. Mayo Clin Proc 1990, 65:1214–1221.

    PubMed  CAS  Google Scholar 

  6. Carman WJ, Sowers M, Hawthorne VM, et al.: Obesity as a risk factor for osteoarthritis of the hand and wrist: a prospective study. Am J Epidemiol 1994, 139:119–129.

    PubMed  CAS  Google Scholar 

  7. Bagge E, Bjelle A, Svanborg A: Radiographic osteoarthritis in the elderly. A cohort comparison and a longitudinal study of the 70-year-old people in Goteborg. Clin Rheumatol 1992, 11:486–491.

    Article  PubMed  CAS  Google Scholar 

  8. Chaisson CE, Zhang Y, McAlindon TE, et al.: Radiographic hand osteoarthritis: incidence, patterns, and influence of pre-existing disease in a population based sample. J Rheumatol 1997, 24:1509–1513.

    Google Scholar 

  9. van Saase JL, van Romunde LK, Cats A, et al.: Epidemiology of osteoarthritis: Zoetermeer survey. Comparison of radiological osteoarthritis in a Dutch population with that in 10 other populations. Ann Rheum Dis 1989, 48:271–280.

    Article  PubMed  Google Scholar 

  10. Tepper S, Hochberg MC: Factors associated with hip osteoarthritis: data from the First National Health and Nutrition Examination Survey (NHANES-I). Am J Epidemiol 1993, 55A:545–557.

    Google Scholar 

  11. Odding E, Valkenburg HA, Algra D, et al.: Associations of radiological osteoarthritis of the hip and knee with locomotor disability in the Rotterdam study. Ann Rheum Dis 1998, 57:203–208.

    PubMed  CAS  Google Scholar 

  12. Nevitt MC, Xu L, Zhang Y, et al.: Very low prevalence of hip osteoarthritis among Chinese elderly in Beijing, compared with whites in the United States. Arthritis Rheum 2002, 46:1773–1779.

    Article  PubMed  Google Scholar 

  13. Zhang Y, Xu L, Nevitt MC, et al.: Comparison of the prevalence of knee osteoarthritis between the elderly Chinese population in Beijing and whites in the United States: The Beijing Osteoarthritis Study. Osteoarthritis Cartilage 2001, 44:2065–2071. Elderly Chinese women, despite being, on average, thinner than many white populations, had a higher prevalence of knee osteoarthritis than women in Framingham, Massachusetts. This study highlighted the potential role of genetics and heavy physical activity in association with knee osteoarthritis.

    CAS  Google Scholar 

  14. Spector TD, Cicuttini F, Baker J, et al. Genetic influences on osteoarthritis in women: a twin study. BMJ 1996, 312:940–943.

    PubMed  CAS  Google Scholar 

  15. Felson DT, Couropmitree NN, Chaisson CE, et al.: Evidence for a Mendelian gene in a segregation analysis of generalized radiographic osteoarthritis: the Framingham Study. Arthritis Rheum 1998, 41:1064–1071.

    Article  PubMed  CAS  Google Scholar 

  16. Zhai G, Ding C, Stankovich J, et al.: The genetic contribution to longitudinal changes in knee structure and muscle strength: a sibpair study. Arthritis Rheum 2005, 52:2830–2834. study of sibling offspring of patients who have had a knee replacement for knee osteoarthritis, changes in knee structures that have relevance to the development of osteoarthritis, such as changes in medial tibial cartilage volume, lateral tibial bone size, progression of chondral defects, and muscle strength, were found to be highly heritable

    Article  PubMed  Google Scholar 

  17. Murray RO: The aetiology of primary osteoarthritis of the hip. Br J Radiol 1965, 38:810–824.

    Article  PubMed  CAS  Google Scholar 

  18. Stulberg SD, Cordell LD, Harris WH, et al.: Unrecognized childhood hip disease: a major cause of idiopathic osteoarthritis of the hip. Hip 1975, 3:212–230.

    Google Scholar 

  19. Lane NE, Lin P, Christiansen L, et al.: Association of mild acetabular dysplasia with an increased risk of incident hip osteoarthritis in elderly white women: the study of osteoporotic fractures. Arthritis Rheum 2000, 43:400–404.

    Article  PubMed  CAS  Google Scholar 

  20. Sharma L: Epidemiology of osteoarthritis. In Osteoarthritis edn 3. Edited by Moskowitz RW, Howell DS, Altman RD, et al. Philadelphia: W.B. Saunders; 2001:3–27.

    Google Scholar 

  21. Cooper C, Snow S, McAlindon TE, et al.: Risk factors for the incidence and progression of radiographic knee osteoarthritis. Arthritis Rheum 2000, 43:995–1000.

    Article  PubMed  CAS  Google Scholar 

  22. Gelber AC, Hochberg MC, Mead LA, et al.: Joint injury in young adults and risk for subsequent knee and hip osteoarthritis. Ann Intern Med 2000, 133:321–328. In his prospective study (with average follow-up of 36 years), knee and hip injury at cohort entry or during follow-up substantially increased the risk for subsequent osteoarthritis at that site. This suggests that such persons constitute a high-risk group and are an ideal population to target for primary prevention of osteoarthritis

    PubMed  CAS  Google Scholar 

  23. Saltzman CL, Salamon ML, Blanchard GM, et al.: Epidemiology of ankle arthritis: report of a consecutive series of 639 patients from a tertiary orthopaedic center. Iowa Orthop J 2005, 25:44–46.

    PubMed  Google Scholar 

  24. Buckwalter JA, Saltzman C, Brown T: The impact of osteoarthritis. Clin Orthop Relat Res 2004, 427S:6–15.

    Article  Google Scholar 

  25. Rossignol M, Leclerc A, Allaert FA, et al.: Primary osteoarthritis of hip, knee, and hand in relation to occupational exposure. Occup Environ Med 2005, 62:772–777.

    Article  PubMed  CAS  Google Scholar 

  26. Maetzel A, Makela M, Hawker G, et al.: Osteoarthritis of the hip and knee and mechanical occupational exposure-a systematic over view of the evidence. J Rheumatol 1997, 24:1599–1607.

    PubMed  CAS  Google Scholar 

  27. McAlindon TE, Wilson PW, Aliabadi P, et al.: Level of physical activity and the risk of radiographic and symptomatic knee osteoarthritis in the elderly: the Framingham study. Am J Med 1999, 106:151–157. Data from the Framingham cohort suggested heavy physical activity is an important risk factor for the development of knee osteoarthritis in the elderly. Light and moderate activities did not appear to increase risk.

    Article  PubMed  CAS  Google Scholar 

  28. Vingard E, Alfredsson L, Goldie I, et al.: Sports and osteoarthrosis of the hip. An epidemiologic study. Am J Sports Med 1993, 21:195–200.

    PubMed  CAS  Google Scholar 

  29. Schipplein OD, Andriacchi TP: Interaction between active and passive knee stabilizers during level walking. J Orthop Res 1991, 9:113–119.

    Article  PubMed  CAS  Google Scholar 

  30. Felson DT, Anderson JJ, Naimark A, et al.: Obesity and knee osteoarthritis. The Framingham Study. Ann Intern Med 1988, 109:18–24.

    PubMed  CAS  Google Scholar 

  31. Sowers MF: Epidemiology of risk factors for osteoarthritis: systemic factors. Current Opin Rheum 2001, 13:447–451.

    Article  CAS  Google Scholar 

  32. Sowers MF, Lachance L, Jamadar D, et al.: The associations of bone mineral density and bone turnover markers with osteoarthritis of the hand and knee in pre-and perimenopausal women. Arthritis Rheum 1999, 42:483–489.

    Article  PubMed  CAS  Google Scholar 

  33. Zhang Y, Hannan MT, Chaisson CE, et al.: Bone mineral density and risk of incident and progressive radiographic knee osteoarthritis in women: the Framingham Study. J Rheumatol 2000, 27:1032–1037.

    PubMed  CAS  Google Scholar 

  34. Cicuttini FM, Spector T, Baker J: Risk factors for osteoarthritis in the tibiofemoral and patellofemoral joints of the knee. J Rheumatol 1997, 24:1164–1167.

    PubMed  CAS  Google Scholar 

  35. Samanta A, Jones A, Regan M, et al.: Is osteoarthritis in women affected by hormonal changes or smoking? Br J Rheumatol 1993, 32:366–370.

    Article  PubMed  CAS  Google Scholar 

  36. Wluka AE, Davis SR, Bailey M, et al.: Users of oestrogen replacement therapy have more knee cartilage than non-users. Ann Rheum Dis 2001, 60:332–336.

    Article  PubMed  CAS  Google Scholar 

  37. Nevitt MC, Cummings SR, Lane NE, et al.: Association of estrogen replacement therapy with the risk of osteoarthritis of the hip in elderly white women. Arch Intern Med 1996, 156:2073–2080.

    Article  PubMed  CAS  Google Scholar 

  38. McAlindon TE, Felson DT, Zhang Y, et al.: Relation of dietary intake and serum levels of vitamin D to progression of osteoarthritis of the knee among participants in the Framingham Study. Ann Intern Med 1996, 125:353–359.

    PubMed  CAS  Google Scholar 

  39. McAlindon TE, Jacques P, Zhang Y, et al.: Do antioxidant micronutrients protect against the development and progression of knee osteoarthritis? Arthritis Rheum 1996, 39:648–656.

    Article  PubMed  CAS  Google Scholar 

  40. Sharma L, Song J, Felson DT, et al.: The role of knee alignment in disease progression and functional decline in knee osteoarthritis. JAMA 2001, 286:188–195. This study was the.rst to demonstrate that in knee osteoarthritis varus alignment increases risk for medial osteoarthritis progression, that valgus alignment increases risk for lateral osteoarthritis progression, and that burden of malalignment predicts decline in physical function over 18 months.

    Article  PubMed  CAS  Google Scholar 

  41. Cicuttini F, Wluka A, Hankin J, et al.: Longitudinal study of the relationship between knee angle and tibiofemoral cartilage volume in subjects with knee osteoarthritis. Rheumatology (Oxford) 2004, 43:321–324.

    Article  CAS  Google Scholar 

  42. Cahue S, Dunlop D, Hayes K, et al.: Varus-valgus alignment in the progression of patellofemoral osteoarthritis. Arthritis Rheum 2004, 50:2184–2190.

    Article  PubMed  Google Scholar 

  43. Sharma L, Lou C, Cahue S, et al.: The mechanism of effect of obesity in knee osteoarthritis: the mediating role of malalignment. Arthritis Rheum 2000, 43:568–575.

    Article  PubMed  CAS  Google Scholar 

  44. Felson DT, Goggins J, Niu J, et al.: The effect of body weight on progression of knee osteoarthrtis is dependent on alignment. Arthritis Rheum 2004, 50:3904–3909.

    Article  PubMed  Google Scholar 

  45. Felson D, McLaughlin S, Goggins J, et al.: Bone marrow edema and its relation to progression of knee osteoarthritis. Ann Intern Med 2003, 139:330–336.

    PubMed  Google Scholar 

  46. Chang A, Hayes K, Dunlop D, et al.: Thrust during ambulation and progression of knee osteoarthritis. Arthritis Rheum 2004, 50:3897–3903.

    Article  PubMed  Google Scholar 

  47. Miyazaki T, Wada M, Kawahara H, et al.: Dynamic load at baseline can predict radiographic disease progression in medial compartment knee osteoarthritis. Ann Rheum Dis 2002, 61:617–622.

    Article  PubMed  CAS  Google Scholar 

  48. Chang A, Hayes K, Dunlop D, et al.: Hip abduction moment and protection against medial tibiofemoral osteoarthritis progression. Arthritis Rheum 2005, 52:3515–3519.

    Article  PubMed  Google Scholar 

  49. Baker K, McAlindon T: Exercise for knee osteoarthritis. Curr Opin Rheumatol 2000, 12:456–463.

    Article  PubMed  CAS  Google Scholar 

  50. van Baar ME, Assendelft WJJ, Joost D, et al.: Effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: a systematic review of randomized clinical trials. Arthritis Rheum 1999, 42:1361–1369.

    Article  PubMed  Google Scholar 

  51. Slemenda C, Heilman D, Brandt K, et al.: Reduced quadriceps strength relative to body weight: a risk factor for knee osteoarthritis in women? Ann Rheum Dis 1998, 41:1951–1959.

    CAS  Google Scholar 

  52. Brandt KD, Heilman DK, Slemenda C, et al.: Quadriceps strength in women with radiographically progressive osteoarthritis of the knee and those with stable radiographic changes. J Rheumatol 1999, 26:2431–2437. In this study there was not a significant difference in quadriceps strength between subjects with radiographically stable osteoarthritis and those whose joint damage progressed. This suggests that factors other than quadriceps weakness are more important determinants of osteoarthritis progression.

    PubMed  CAS  Google Scholar 

  53. Sharma L, Dunlop DD, Cahue S, et al.: Quadriceps strength and osteoarthritis progression in malaligned and lax knees. Ann Intern Med 2003, 138:613–619.

    PubMed  Google Scholar 

  54. Corti MC, Rigon C: Epidemiology of osteoarthritis: prevalence, risk factors and functional impact. Aging Clin Exp Res 2003, 15:359–363.

    PubMed  Google Scholar 

  55. Guccione AA, Felson DT, Anderson JJ, et al.: The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health 1994, 84:351–358.

    Article  PubMed  CAS  Google Scholar 

  56. Zhang Y, Niu J, Kally-Hayes M, et al.: Prevalence of symptomatic hand osteoarthritis and its impact on functional status among the elderly. Am J Epidemiol 2002, 156:1021–1027.

    Article  PubMed  Google Scholar 

  57. Rejeski WJ, Miller ME, Foy C, et al.: Self-efficacy and the progression of functional limitations and selfreported disability in adults with knee pain. J Gerontol 2001, 56B:s261-s265.

    Google Scholar 

  58. Sharma L, Cahue S, Song J, et al.: Physical functioning over 3 years in knee osteoarthritis. Arthritis Rheum 2003, 48:3359–3370. This longitudinal study identified factors that predict a poor physical function outcome over 3 years in persons with knee osteoarthritis. Factors placing persons at a greater risk for poor function outcome included laxity, proprioceptive inaccuracy, age, BMI, and knee pain intensity. Factors protecting against a poor function outcome included strength, the psychosocial factors mental health, self-efficacy, and social support, as well as the activity level as measured by the amount of aerobic exercise per week.

    Article  PubMed  Google Scholar 

  59. van Gool CH, Penninx BWJH, Kempen GIJM, et al.: Effects of exercise adherence on physical function among overweight older adults with knee osteoarthritis. Arthritis Rheum 2005, 53:24–32.

    Article  PubMed  Google Scholar 

  60. Davis MA, Ettinger WH, Neuhaus JM, et al.: Knee osteoarthritis and physical functioning: evidence from the NHANES I Epidemiologic Follow-up Study. J Rheumatol 1991, 18:591–598.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Issa, S.N., Sharma, L. Epidemiology of osteoarthritis: An update. Curr Rheumatol Rep 8, 7–15 (2006). https://doi.org/10.1007/s11926-006-0019-1

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11926-006-0019-1

Keywords

Navigation