{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T03:14:01Z","timestamp":1788232441557,"version":"build-2803163510"},"reference-count":48,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"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":["82373653"],"award-info":[{"award-number":["82373653"]}],"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":["82372428"],"award-info":[{"award-number":["82372428"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aimed to assess the long\u2010term trends in cross\u2010country inequalities related to the burden of osteoarthritis from 1990 to 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data on osteoarthritis incidence, prevalence, years lived with disability, and sociodemographic index (SDI) were extracted from the Global Burden of Diseases Study 2021. Slope index of inequality and concentration index were calculated to quantify the absolute and relative cross\u2010country inequalities in osteoarthritis burden. Joinpoint regression was used to measure the average annual percentage change. Decomposition analysis was applied to quantify the contributions of population growth, population aging, and epidemiological changes to changes in osteoarthritis burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Globally, more than 600 million people had osteoarthritis in 2021, with an increase of 137.03% since 1990. Significant absolute and relative SDI\u2010related inequalities in osteoarthritis burden were observed across 204 countries\/territories, with the burden disproportionately concentrated among countries\/territories with higher SDI rankings. The slope index of inequality for all\u2010age osteoarthritis prevalence rose from 5759.73 to 11151.93, while the concentration index increased from 0.26 to 0.28 from 1990 to 2021. Sensitivity analyses using age\u2010standardized rates showed that the direction of inequality remained unchanged, whereas the increasing trend was attenuated for total osteoarthritis and persisted for knee osteoarthritis and other types of osteoarthritis. Population growth was the largest contributor to the increase in osteoarthritis burden, and population aging became the second\u2010largest contributor globally after 2011.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Osteoarthritis is a growing health problem with widening cross\u2010country inequalities, suggesting an urgent need to adopt specific measures according to different levels of sociodemographic development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1756-185x.70733","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T06:53:12Z","timestamp":1781851992000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Temporal Trends and Cross\u2010Country Inequalities in the Burden of Osteoarthritis, 1990\u20132021: Findings From the Global Burden of Disease Study 2021"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1466-5348","authenticated-orcid":false,"given":"Haowei","family":"Chen","sequence":"first","affiliation":[{"name":"Clinical Research Centre, Zhujiang Hospital Southern Medical University  Guangzhou Guangdong China"},{"name":"Institute of Exercise and Rehabilitation Science Zhujiang Hospital of Southern Medical University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3044-170X","authenticated-orcid":false,"given":"Lei","family":"Si","sequence":"additional","affiliation":[{"name":"School of Health Sciences Western Sydney University  Campbelltown New South Wales Australia"},{"name":"Translational Health Research Institute Western Sydney University  Penrith New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2343-084X","authenticated-orcid":false,"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[{"name":"China\u2010Australia Joint Research Centre for Infectious Diseases, School of Public Health Xi'an Jiaotong University Health Science Centre  Xi'an Shanxi China"},{"name":"Melbourne Sexual Health Centre Alfred Health  Melbourne Victoria Australia"},{"name":"Central Clinical School, Faculty of Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3197-752X","authenticated-orcid":false,"given":"David J.","family":"Hunter","sequence":"additional","affiliation":[{"name":"Clinical Research Centre, Zhujiang Hospital Southern Medical University  Guangzhou Guangdong China"},{"name":"Institute of Exercise and Rehabilitation Science Zhujiang Hospital of Southern Medical University  Guangzhou Guangdong China"},{"name":"Sydney Musculoskeletal Health, Faculty of Medicine and Health Science, Kolling Institute University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Rheumatology, Royal North Shore Hospital University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4450-8194","authenticated-orcid":false,"given":"Vicky","family":"Duong","sequence":"additional","affiliation":[{"name":"Sydney Musculoskeletal Health, Faculty of Medicine and Health Science, Kolling Institute University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2408-2456","authenticated-orcid":false,"given":"Xiaomeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Clinical Research Centre, Zhujiang Hospital Southern Medical University  Guangzhou Guangdong China"},{"name":"Institute of Exercise and Rehabilitation Science Zhujiang Hospital of Southern Medical University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4269-3899","authenticated-orcid":false,"given":"Peihua","family":"Cao","sequence":"additional","affiliation":[{"name":"Clinical Research Centre, Zhujiang Hospital Southern Medical University  Guangzhou Guangdong China"},{"name":"Institute of Exercise and Rehabilitation Science Zhujiang Hospital of Southern Medical University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9251-2331","authenticated-orcid":false,"given":"Han","family":"Cen","sequence":"additional","affiliation":[{"name":"Clinical Research Centre, Zhujiang Hospital Southern Medical University  Guangzhou Guangdong China"},{"name":"Institute of Exercise and Rehabilitation Science Zhujiang Hospital of Southern Medical University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1391-5838","authenticated-orcid":false,"given":"Su'an","family":"Tang","sequence":"additional","affiliation":[{"name":"Clinical Research Centre, Zhujiang Hospital Southern Medical University  Guangzhou Guangdong China"},{"name":"Institute of Exercise and Rehabilitation Science Zhujiang Hospital of Southern Medical University  Guangzhou Guangdong China"},{"name":"Department of Spinal Surgery, Orthopedic Medical Center, Zhujiang Hospital Southern Medical University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7056-2947","authenticated-orcid":false,"given":"Tianyu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The Third Affiliated Hospital of Southern Medical University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6611-2959","authenticated-orcid":false,"given":"Yan","family":"He","sequence":"additional","affiliation":[{"name":"Microbiome Medicine Centre, Department of Laboratory Medicine, Zhujiang Hospital Southern Medical University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9479-730X","authenticated-orcid":false,"given":"Changhai","family":"Ding","sequence":"additional","affiliation":[{"name":"Clinical Research Centre, Zhujiang Hospital Southern Medical University  Guangzhou Guangdong China"},{"name":"Institute of Exercise and Rehabilitation Science Zhujiang Hospital of Southern Medical University  Guangzhou Guangdong China"},{"name":"Clinical Research Centre, Guangzhou First People's Hospital, School of Medicine South China University of Technology  Guangzhou Guangdong China"},{"name":"Menzies Institute for Medical Research University of Tasmania  Hobart Tasmania Australia"},{"name":"Clinical Research Centre, Beijing Tsinghua Changgung Hospital, Tsinghua Medicine Tsinghua University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3913-2564","authenticated-orcid":false,"given":"Zhaohua","family":"Zhu","sequence":"additional","affiliation":[{"name":"Clinical Research Centre, Zhujiang Hospital Southern Medical University  Guangzhou Guangdong China"},{"name":"Institute of Exercise and Rehabilitation Science Zhujiang Hospital of Southern Medical University  Guangzhou Guangdong China"},{"name":"Sydney Musculoskeletal Health, Faculty of Medicine and Health Science, Kolling Institute University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Rheumatology, Royal North Shore Hospital University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(19)30417\u20109"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.19675"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2665\u20109913(23)00163\u20107"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.42089"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard\u20102023\u2010224840"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(20)32230\u20103"},{"key":"e_1_2_12_8_1","unstructured":"Food and Drug Administration \u201cOsteoarthritis: Structural Endpoints for the Development of Drugs \u201d(2023) https:\/\/www.fda.gov\/regulatory\u2010information\/search\u2010fda\u2010guidance\u2010documents\/osteoarthritis\u2010structural\u2010endpoints\u2010development\u2010drugs."},{"key":"e_1_2_12_9_1","unstructured":"World Health Organization \u201cWHO's Work on the UN Decade of Healthy Ageing (2021\u20132030) \u201d(2023) https:\/\/www.who.int\/initiatives\/decade\u2010of\u2010healthy\u2010ageing."},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature06516"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586\u2010018\u20100457\u20108"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(24)00476\u20108"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(23)02750\u20102"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2023.10.012"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010019\u20103016\u2010z"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010021\u201011793\u20107"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102019\u2010216515"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2025.02.006"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756\u2010185x.15285"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2024.102382"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medj.2024.04.009"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(24)00757\u20108"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(24)00933\u20104"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/(sici)1097\u20100258(20000215)19:3<335::aid\u2010sim336>3.0.co;2\u2010z"},{"key":"e_1_2_12_25_1","volume-title":"Handbook on Health Inequality Monitoring: With a Special Focus on Low\u2010and Middle\u2010Income Countries","author":"World Health Organization","year":"2013"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102022\u2010073043"},{"issue":"3","key":"e_1_2_12_27_1","first-page":"171","article-title":"Standardization and Decomposition of Rates From Cross\u2010Classified Data","volume":"50","author":"Gupta P. D.","year":"1994","journal-title":"Genus"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003138"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0216613"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2214\u2010109x(19)30360\u20102"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25322"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939\u2010023\u201001988\u20102"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2023.103326"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.14.04200"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25617"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.2147\/cia.S174741"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742\u20101241.2007.01423.x"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaf327"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports\u20102023\u2010107625"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ard.2025.01.019"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2023.06.010"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2021.03.011"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2018.06.002"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2025.05.011"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13103390"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard\u20102023\u2010225324"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.5302"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2018.07.002"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(22)00532\u20103"}],"container-title":["International Journal of Rheumatic Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1756-185x.70733","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1756-185x.70733","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1756-185x.70733","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T02:53:50Z","timestamp":1788231230000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1756-185x.70733"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":48,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/1756-185x.70733"],"URL":"https:\/\/doi.org\/10.1111\/1756-185x.70733","archive":["Portico"],"relation":{},"ISSN":["1756-1841","1756-185X"],"issn-type":[{"value":"1756-1841","type":"print"},{"value":"1756-185X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2025-12-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70733"}}