{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T03:18:03Z","timestamp":1788319083740,"version":"build-2803163510"},"reference-count":17,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,7,10]],"date-time":"2021-07-10T00:00:00Z","timestamp":1625875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["P30AR072580"],"award-info":[{"award-number":["P30AR072580"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["P60AR049465"],"award-info":[{"award-number":["P60AR049465"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["P60AR064166"],"award-info":[{"award-number":["P60AR064166"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["P60AR30701"],"award-info":[{"award-number":["P60AR30701"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000130","name":"National Center for Chronic Disease Prevention and Health Promotion","doi-asserted-by":"publisher","award":["U01DP003206"],"award-info":[{"award-number":["U01DP003206"]}],"id":[{"id":"10.13039\/100000130","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000130","name":"National Center for Chronic Disease Prevention and Health Promotion","doi-asserted-by":"publisher","award":["U01DP006266"],"award-info":[{"award-number":["U01DP006266"]}],"id":[{"id":"10.13039\/100000130","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ACR Open Rheumatology"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe point prevalence of knee symptoms, radiographic knee osteoarthritis (rKOA), severe rKOA, and symptomatic rKOA at four time points in the longitudinal, population\u2010based Johnston County Osteoarthritis Project (JoCo OA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Data were from 2573 JoCo OA participants with up to 18 years of follow\u2010up (1999\u20102018) and standardized fixed\u2010flexion knee radiographs read by a single, reliable expert musculoskeletal radiologist. The four outcomes were\n                      <jats:italic>1<\/jats:italic>\n                      ) self\u2010reported knee symptoms, defined by \u201cOn most days, do you have pain, aching, or stiffness in your right\/left knee?\u201d;\n                      <jats:italic>2<\/jats:italic>\n                      ) rKOA, defined as a Kellgren\u2010Lawrence grade (KLG) of 2 to 4);\n                      <jats:italic>3<\/jats:italic>\n                      ) severe rKOA, defined as a KLG of 3 or 4; and\n                      <jats:italic>4<\/jats:italic>\n                      ) symptomatic rKOA, defined as both symptoms and rKOA in the same joint. Weighted prevalence estimates and 95% confidence intervals (CIs) were generated overall and by age group, sex, race, and body mass index (BMI).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Most recently (2017\u20102018, T4), the overall prevalence (percentage) of knee symptoms, rKOA, severe rKOA, and symptomatic rKOA was 41% (95% CI: 35\u201047%), 61% (95% CI: 56\u201067%), 35% (95% CI: 30\u201040%), and 30% (95% CI: 24\u201035%), respectively. From time point T1 to T4, prevalence increased for rKOA, severe rKOA, and symptomatic rKOA but not for knee symptoms. The prevalence of both severe rKOA (17\u201039%) and symptomatic rKOA (23\u201030%) was consistently higher among women. The prevalence of all outcomes was higher among those with higher BMI and among Black participants at all time points, particularly rKOA (35\u201069%) and severe rKOA (22\u201046%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These updated estimates demonstrate a large and increasing burden of knee OA, particularly among women and Black individuals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr2.11295","type":"journal-article","created":{"date-parts":[[2021,7,10]],"date-time":"2021-07-10T07:19:36Z","timestamp":1625901576000},"page":"558-565","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["The Prevalence of Knee Symptoms, Radiographic, and Symptomatic Osteoarthritis at Four Time Points: The Johnston County Osteoarthritis Project, 1999\u20102018"],"prefix":"10.1002","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9344-7877","authenticated-orcid":false,"given":"Amanda E.","family":"Nelson","sequence":"first","affiliation":[{"name":"University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Hu","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liubov","family":"Arbeeva","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Alvarez","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0022-1025","authenticated-orcid":false,"given":"Rebecca J.","family":"Cleveland","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd A.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3919-0721","authenticated-orcid":false,"given":"Louise B.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention Atlanta Georgia United States"},{"name":"Optum Life Sciences Eden Prairie Minnesota United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles G.","family":"Helmick","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention Atlanta Georgia United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh F.","family":"Callahan","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan B.","family":"Renner","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne M.","family":"Jordan","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1205-2759","authenticated-orcid":false,"given":"Yvonne M.","family":"Golightly","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel 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