Prevalence of hip and knee osteoarthritis in Europe: a systematic review and meta-analysis

Osteoarthritis (OA) is a leading cause of pain and disability worldwide, with the hip and knee being the most commonly affected major joints. These forms of OA contribute substantially to individual suffering, reduced quality of life, and increased healthcare costs. While global estimates of OA prevalence are available, there is a paucity of reliable, region-specific data for Europe. This systematic review aims to address the following questions: (1) What is the prevalence of hip and knee OA in Europe? (2) How does this prevalence vary across different regions? (3) How does the reported prevalence differ depending on the diagnostic methods used?

A systematic literature search was conducted in PubMed and Embase for studies published between January 1, 2000, and November 14, 2024. Study quality and risk of bias were assessed independently using the Joanna Briggs Institute (JBI) checklist. Pooled prevalence estimates were calculated using random-effects meta-analysis, and subgroup analyses were performed by diagnostic method and geographic region. The review was prospectively registered with PROSPERO (CRD42022302976) and conducted in accordance with PRISMA guidelines.

Twenty nine studies were included, comprising data from 6,767,340 individuals for hip OA and 6,805,777 for knee OA. The pooled prevalence of hip OA in Europe was estimated at 6% (95% CI: 3-9%), and for knee OA, 10% (95% CI: 7-14%). Subgroup analysis by diagnostic method revealed that prevalence was highest for hip OA when using Kellgren-Lawrence grade ≥ 2 (11.5%, 95% CI: 5.0-24.5%) and for knee OA when using American College of Rheumatology (ACR) criteria (14.5%, 95% CI: 7.6-25.9%). Subgroup analysis by European region showed that hip OA prevalence ranged from 2% in Eastern Europe to 7% in Southern Europe, while knee OA ranged from 7% in Northern Europe to 19% in Eastern Europe.

Hip and knee OA are common in Europe, though prevalence varies widely across studies and diagnostic approaches.