Global, regional, and national burden of Knee Osteoarthritis, 1990-2023 and projections to 2038: a systemic analysis for the Global Burden of Disease Study 2023

Hai Liu^1,2Youkang Zhu^1,2Qi Song^1,2XIAO LIU^1,2Zhaochuan Xu^1,2Yu Liang^1,2Chen Wang^1,2Zeyu Liu³Xifang Liu^1*

• ¹Xi'an Honghui Hospital, Xi'an, Shaanxi Province, China
• ²Xi'an Physical Education University, Xi'an, China
• ³Ulanqab Hospital of Traditional Chinese and Mongolian Medicine, Ulanqab, Inner Mongolia, China

Knee osteoarthritis (KOA) is a significant global health issue. This study aims to analyze the trends in the global, regional, and national burden of KOA from 1990 to 2023, and predict future trends.Methods: This study utilized the 2023 Global Burden of Disease (GBD) database to analyze the age-standardized rates(ASR) of incidence, prevalence and years Lived with Disability (YLDs) of knee osteoarthritis (KOA) from 1990 to 2023 at the global, regional, and national levels. Joinpoint regression was employed to assess disease burden trends during this period, complemented by the Age-Period-Cohort (APC) model for trend analysis. Additionally, the Bayesian Age-Period-Cohort (BAPC) model was used to forecast future incidence trends.From 1990 to 2023, the global burden of KOA increased significantly. The ASR of incidence rose from 330.18 to 348.92 per 100,000, representing a 5.68% increase, the number of cases grew from 16.24 million to 36.56 million, with the ASR of prevalence increasing from 4532.50 to 4855.53 per 100,000. years Lived with Disability(YLDs) rose from 5.16 million to 12.59 million, and the ASR of years Lived with Disability(YLDs) increased by 9.43 per 100,000. The Sociodemographic Index(SDI) classification highlighted disparities, with the highest burden increase observed in high SDI regions and the least in low SDI regions. East Asia and Southeast Asia experienced a continuous worsening of the burden, with South Korea, Singapore, Brunei, Japan, and Taiwan (China Province) ranking among the top five across all indicators in 2023. The annual average percentage change (AAPC) in global ASR of incidence, prevalence and years Lived with Disability(YLDs) was 0.17%, 0.22%, and 0.22%, respectively.As the global population ages and grows, the burden of KOA is expected to continue increasing, particularly in low SDI regions. Although high SDI regions show rising incidence and prevalence rates, low SDI regions continue to experience growth trend. Targeted interventions are urgently needed to reduce the future burden of KOA in resource-limited settings and address the growing disparities in global disease outcomes. Through comprehensive analysis of incidence, prevalence, and years Lived with Disability (YLDs), this study provides important insights for future health policy development.