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Osteoarthritis

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Internationally, prevalence estimates for osteoarthritis show wide variability depending on the age and sex of the studied population, the method of case identification used, and the specificity of joint sites included. Currently, there is no generally agreed “gold standard” for identifying cases of osteoarthritis in epidemiologic studies. Despite this lack of standardisation, it is consistently demonstrated in population-based studies, worldwide, that osteoarthritis prevalence is positively associated with increasing age and that the greatest disease burden is attributable to involvement of the hip or knee joints. To estimate the true burden of osteoarthritis involving the hips or knees, comprehensive accounting of all associated morbidity is required. The identification of modifiable risk factors for disease incidence and progression is needed.

Section snippets

Case definitions

The major purposes of case definitions are to distinguish between individuals who have the disease from those who do not and to promote comparability between different research studies. Case-definition methods need to be distinguished from diagnostic criteria, which are used in clinical practice to differentiate between different types of illness to determine the appropriate management strategy and to enhance communication among the professionals. In research settings, medical diagnosis can

Mortality

Osteoarthritis is not regarded as a fatal disease and only a handful of studies have examined mortality among individuals with osteoarthritis. In 2007, diseases of the musculoskeletal system were reported as the underlying cause of death in less than 1% of all registered deaths in Australia. A further 3% of registered deaths had diseases of the musculoskeletal system as a contributing or associated cause of death [24]. The standardised death rate for arthritis and musculoskeletal diseases has

Prevalence

Internationally, prevalence estimates for osteoarthritis show wide variability depending on the age and sex of the studied population, the method of case identification used and the specificity of joint sites included. There have only been a few, large, population-based surveys that have included a radiographic examination of the hip or knee allowing a case definition of symptomatic knee or hip osteoarthritis, if pain is present in a joint with radiographically evident osteoarthritis. As

Risk factors

The aetiology of osteoarthritis is a complex process and is subject to ongoing investigation [49], [50], [51]. It has been suggested that disease process in osteoarthritis reflects “an age-related dynamic reaction pattern of a joint in response to insult or injury” ([10], p. 3), with a wide range of systemic, genetic, biomechanical and environmental factors contributing to the development of this condition [52]. The results suggest that the relative importance of the identified risk factors

Summary

The research presented in this article identifies osteoarthritis of the hip and knee as a substantial and increasing burden on society. Several gaps in the current understating of the burden of osteoarthritis have also been identified, including osteoarthritis prevalence and mortality. The lack of uniformity in case definitions used to identify cases of osteoarthritis in epidemiological studies, along with differences in survey methodology, make it difficult to draw reliable conclusions about

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    Formerly, Centre for Rheumatic Diseases, University of Melbourne.

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