{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:53:06Z","timestamp":1793332386740,"version":"4.5.0"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82372428"],"award-info":[{"award-number":["82372428"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82373653"],"award-info":[{"award-number":["82373653"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study examined the global and regional temporal changes in cross\u2010country inequalities of site\u2010specific osteoarthritis (OA) burden from 1990 to 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Age\u2010standardized years lived with disability rates (ASYRs) for site\u2010specific OA across 204 countries and territories were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. The slope index of inequality (SII) and the concentration index (CCI) were calculated to quantify the absolute and relative cross\u2010country inequalities. Average annual percent change (AAPC) was used to assess the temporal changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 1990 to 2021, the ASYR of OA increased regardless of the joint affected globally. The SII of total OA exhibited an improving cross\u2010country inequality among higher sociodemographic index (SDI) countries and territories, decreasing from 77.26 (95% confidence interval [CI] 69.32\u201385.20) to 69.85 (95% CI 60.67\u201379.02). Similarly, the CCI of total OA decreased from 0.0815 (95% CI 0.0732\u20130.0897) to 0.0622 (95% CI 0.0551\u20130.0693). However, most regions exhibited worsening cross\u2010country inequalities among higher SDI countries and territories. Central sub\u2010Saharan Africa showed the largest worsening inequality in SII (AAPC 4.55, 95% CI 2.83\u20136.29), whereas east Asia showed the largest worsening inequality in CCI (AAPC 1.96, 95% CI 1.48\u20132.43). Hand OA showed consistently improving absolute and relative cross\u2010country inequalities among higher SDI countries and territories, whereas other OA showed consistently worsening inequalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The cross\u2010country inequalities of OA burden have persisted and even worsened in some regions over the past decades. Targeted prevention and management strategies according to geographic location and affected joint are pivotal to reduce the growing OA burden and achieve equity in health outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.25617","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T07:34:35Z","timestamp":1754292875000},"page":"215-226","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Global and Regional Temporal Changes in Cross\u2010Country Inequalities of Site\u2010Specific Osteoarthritis Burden, 1990 to 2021"],"prefix":"10.1002","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1466-5348","authenticated-orcid":false,"given":"Haowei","family":"Chen","sequence":"first","affiliation":[{"name":"Zhujiang Hospital of Southern Medical University  Guangzhou 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