Updated prevalence of radiographic and symptomatic hip osteoarthritis: Findings from the Johnston County Health Study

To provide updated, population-based, weighted prevalence estimates of radiographic and symptomatic hip osteoarthritis (HOA), by age, sex, race/ethnicity, and BMI group using data from the Johnston County Health Study (JoCoHS).

JoCoHS is a community-based study of adults aged 35-70 years in Johnston County, North Carolina enrolled between 2019 and 2024. Data from 902 participants were analyzed using sampling weights derived from the 2020 U.S. Census. Participants underwent bilateral supine hip radiography, scored using Kellgren-Lawrence grade (KLG), and symptom assessments. Weighted prevalence estimates and 95% confidence intervals (CI) for hip symptoms, radiographic hip OA (rHOA, KLG ≥ 2), severe rHOA (KLG ≥ 3), and symptomatic rHOA (sxHOA) were estimated overall and by subgroups.

Participants had a mean age of 52.5 years and a mean BMI of 33.1 kg/m²; 55% were female, 22% non-Hispanic Black, 13% Hispanic, and 7% reported prior hip injury. Weighted prevalence estimates for hip symptoms, rHOA, severe rHOA, and sxHOA were 43%, 18%, 4%, and 8%, respectively. rHOA was more common in males than females (24% vs 13%), whereas symptoms were more common in females than males (50% vs 35%). Prevalence of all outcomes was highest among those with obesity and hip injury and lowest for younger age groups.

These findings provide updated, population-representative prevalence estimates of HOA outcomes in a contemporary and diverse cohort. HOA remains a substantial burden, particularly among individuals with obesity and prior hip injury, with presentation differing by sex. These results support targeted clinical screening in high-risk subgroups.