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      The number of persons with symptomatic knee osteoarthritis in the United States: Impact of race/ethnicity, age, sex, and obesity

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          Abstract

          Objective

          The prevalence of symptomatic knee osteoarthritis (OA) has been increasing over the past several decades in the United States concurrent with an aging population and the growing obesity epidemic. We quantify the impact of these factors on the number of persons with symptomatic knee OA in the first decades of 21st century.

          Methods

          We calculated prevalence of clinically diagnosed symptomatic knee OA from the National Health Interview Survey 2007–08 and derived the proportion with advanced disease (Kellgren-Lawrence grades 3–4) using the Osteoarthritis Policy Model, a validated simulation model of knee OA. Incorporating contemporary obesity rates and population estimates, we calculated the number of persons living with symptomatic knee OA.

          Results

          We estimate that about fourteen million persons had symptomatic knee OA, with advanced OA comprising over half of those cases. This includes over three million African American, Hispanic, and other racial/ethnic minorities. Adults under 45 years of age represented nearly two million cases of symptomatic knee OA and individuals between 45 and 65 years of age six million more.

          Conclusion

          Over half of all persons with symptomatic knee OA are younger than 65 years of age. As many of these younger persons will live for three decades or more, there is substantially more time for greater disability to occur and policymakers should anticipate healthcare utilization for knee OA to increase further in upcoming decades. These data emphasize the need for the deployment of innovative prevention and treatment strategies for knee OA, especially among younger persons.

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          Most cited references29

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          The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review.

          To understand the differences in prevalence and incidence estimates of osteoarthritis (OA), according to case definition, in knee, hip and hand joints. A systematic review was carried out in PUBMED and SCOPUS databases comprising the date of publication period from January 1995 to February 2011. We attempted to summarise data on the incidence and prevalence of OA according to different methods of assessment: self-reported, radiographic and symptomatic OA (clinical plus radiographic). Prevalence estimates were combined through meta-analysis and between-study heterogeneity was quantified. Seventy-two papers were reviewed (nine on incidence and 63 on prevalence). Higher OA prevalences are seen when radiographic OA definition was used for all age groups. Prevalence meta-analysis showed high heterogeneity between studies even in each specific joint and using the same OA definition. Although the knee is the most studied joint, the highest OA prevalence estimates were found in hand joints. OA of the knee tends to be more prevalent in women than in men independently of the OA definition used, but no gender differences were found in hip and hand OA. Insufficient data for incidence studies didn't allow us to make any comparison according to joint site or OA definition. Radiographic case definition of OA presented the highest prevalences. Within each joint site, self-reported and symptomatic OA definitions appear to present similar estimates. The high heterogeneity found in the studies limited further conclusions. Copyright © 2011 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
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            Lifetime medical costs of knee osteoarthritis management in the United States: impact of extending indications for total knee arthroplasty.

            The impact of increasing utilization of total knee arthroplasty (TKA) on lifetime costs in persons with knee osteoarthritis (OA) is understudied.
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              Lifetime risk and age at diagnosis of symptomatic knee osteoarthritis in the US.

              To estimate the incidence and lifetime risk of diagnosed symptomatic knee osteoarthritis (OA) and the age at diagnosis of knee OA based on self-reports in the US population.
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                Author and article information

                Journal
                101518086
                37048
                Arthritis Care Res (Hoboken)
                Arthritis Care Res (Hoboken)
                Arthritis care & research
                2151-464X
                2151-4658
                26 August 2016
                03 November 2016
                December 2016
                01 December 2017
                : 68
                : 12
                : 1743-1750
                Affiliations
                [1 ] Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, United States
                [2 ] Section of Clinical Sciences, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, Massachusetts, United States
                [3 ] Harvard Medical School, Boston, Massachusetts, United States
                [4 ] Departments of Epidemiology and Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States
                [5 ] Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Boston, Massachusetts, United States
                [6 ] Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California, United States
                [7 ] Rosalind Russell / Ephraim P. Engleman Rheumatology Research Center, Division of Rheumatology, University of California, San Francisco, San Francisco, California, United States
                [8 ] Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
                [9 ] Department of Rheumatology, Royal North Shore Hospital, St. Leonards, New South Wales, Australia
                [10 ] J.B. Snow Biomechanics Laboratory, Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, United States
                [11 ] Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
                [12 ] Section on Rheumatology and Immunology, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
                [13 ] Center for Biomolecular Imaging, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
                [14 ] Section of Rheumatology, Yale School of Medicine, New Haven, Connecticut, United States
                [15 ] Center for Outcomes Research and Evaluation, Yale–New Haven Hospital, New Haven, Connecticut, United States
                [16 ] Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, United States
                [17 ] Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States
                Author notes
                Correspondence: Elena Losina, PhD, Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopaedic Surgery, Brigham and Women's Hospital, 75 Francis Street, BC 4-016, Boston, MA 02115, elosina@ 123456partners.org , Phone: (617) 732-5338; Fax: (617) 525-7900
                Article
                PMC5319385 PMC5319385 5319385 nihpa775448
                10.1002/acr.22897
                5319385
                27014966
                da19551b-3764-4b00-b0bf-3b96797d47cc
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