Public health burden, epidemiology, importance of osteoarthritis as a health issue

Osteoarthritis (OA) is the leading cause of pain and disability in most of the world. As a disease associated with older age, the prevalence of OA will escalate as the number of adults over 60-years of age is expected to double over the next four-decades. As such, the importance of OA as a public health problem will also increase. Currently, the WHO estimates that 9.6% of men and 18% of women have painful OA worldwide. The prevalence of OA varies across environments. For instance, men and women over 60 from a rural area in China had 2.0 and 1.6 times the prevalence of painful knee OA, respectively, compared with their counterparts in Beijing. Similar differences in knee pain are reported in India, though in Pakistan and Bangladesh the prevalence of knee pain is higher in urban rather than rural areas. These differences may be reflective of varying degrees of exposure to known risk factors for OA, which include age, female sex, obesity, previous injury, and occupations with repetitive squatting or kneeling. From a societal perspective, OA is a costly disease. Direct costs come in the form of increased utilization of hospital and medical services, while indirect costs include lost worker productivity. Unfortunately, OA has no known cure. Instead, treatment is focused on prevention, the management of symptoms from pharmacological and non-pharmacological therapies, and total joint replacement. The availability of these therapies varies greatly between developed and non-developed countries and is a public health concern as the prevalence of OA increases.