Analysis of disease burden of osteoarthritis in China from 1990 to 2021 and projections for 2022-2044

To analyze the secular trend of osteoarthritis (OA) disease burden in China from 1990 to 2021 and predict future burden changes spanning 2022-2044 to support targeted public health intervention.

Based on the Global Burden of Disease 2021 (supplemented with partial 2023 GBD data), crude incidence, age-standardized incidence rate (ASIR), disability-adjusted life years (DALYs) and OA prevalence data were retrieved. Joinpoint regression calculated average annual percentage change (AAPC) to assess secular trends; ARIMA and Brown time-series models were selected via AIC and residual diagnosis for future burden prediction, with 95% forecast uncertainty intervals calculated.

National OA prevalent cases increased from 4.65 million in 1990 to 11.65 million in 2021, with the AAPC of ASIR and age-standardized DALY rate reaching 0.43% and 0.49% (all P < 0.001). China's ASIR surpassed the global average after 2003; females sustained higher OA burden than males, incidence peaked among people aged 55-59 years, and DALY loss predominantly clustered in the population ≥85 years. Knee OA dominated the burden across all anatomical subtypes. Forecasts indicate the national ASIR and standardized DALY rate will rise to 589.00/100,000 and 292.02/100,000 by 2044 with inherent predictive uncertainty.

China's overall OA burden has risen substantially and will keep increasing over the next two decades. Females, middle-aged and elderly residents, and patients with knee OA constitute core high-risk groups. These findings provide reliable epidemiological evidence for hierarchical OA prevention and national health policy formulation.