Skip to main content
Log in

Prevalence and risk factors of knee osteoarthritis in Huang-Pu District, Shanghai, China

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript



A community-based survey on the prevalence of knee osteoarthritis (OA) and associated factors was carried out in Shanghai, People’s Republic of China.


Of 2,305 registered residents ≥40 years of age, 2,093 were examined by interview and questionnaire. One hundred ninety knee pain-positive and 510 knee pain-negative subjects received radiography.


Radiographic knee OA (RKOA) was found in 72.1% (137/190) of symptomatic and 41.6% (212/510) of asymptomatic subjects (SKOA and AsKOA, respectively). The estimated prevalences of symptomatic and asymptomatic knee OA in the community were 7.2% and 37.4%, respectively. Women had higher SKOA prevalence than men (9.8% vs 3.7%, P<0.01). Compared with Caucasians, the urban Shanghai population had a higher prevalence of tibiofemoral joint OA.


There was a higher proportion of SKOA than AsKOA (72.1% vs 41.6%), and SKOA was significantly more associated with disability (81.0% vs 26.9%, P<0.01). The prevalence of SKOA increased with age, from 1.3% in the 40–49-year-old age group to 13.2% in the 70+ group. Age, body mass index, and female gender were associated risk factors for knee OA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3A–C

Similar content being viewed by others


  1. van Saase JL, van Romunde LK, Cats A, Vandenbroucke JP, Valkenburg HA (1989) Epidemiology of osteoarthritis: Zoetermeer survey. Comparison of radiological osteoarthritis in a Dutch population with that in 10 other populations. Ann Rheum Dis 48:271–280

    PubMed  Google Scholar 

  2. Felson DT (1988) Epidemiology of hip and knee osteoarthritis. Epidemiol Rev 10:1–28

    CAS  PubMed  Google Scholar 

  3. Zhang Y, Xu L, Nevitt MC, Aliabadi P, Yu W, Qin M et al (2001) Comparison of the prevalence of knee osteoarthritis between the elderly Chinese population in Beijing and whites in the United States: The Beijing Osteoarthritis Study. Arthritis Rheum 44:2065–2071

    Article  CAS  PubMed  Google Scholar 

  4. Kuan-Chia Lin, Hsiao-Yi Lin, Pesus Chou (2000) Community based epidemiological study on hyperuricemia and gout in Kin-Hu, Kinmen. J Rheumatol 27:1045–1050

    PubMed  Google Scholar 

  5. Kellgren JK, Lawrence JS (1963) The epidemiology of chronic rheumatism. Atlas of standard radiographs. Vol 2. Blackwell Scientific, Oxford

  6. Spector TD, Hart DJ, Byrne J et al (1993) Definition of OA of the knee for epidemiological studies. Ann Rheum Dis 52:790–794

    CAS  PubMed  Google Scholar 

  7. Peat G, McCartney R, Croft P (2001) Knee pain and OA in older adults: a review of community burden and current use of primary health care. Ann Rheum Dis 60:91–97

    Article  CAS  PubMed  Google Scholar 

  8. Kellgren JH, Lawrence JS (1958) Osteo-arthrosis and disk degeneration in an urban population. Ann Rheum Dis 17:388–397

    CAS  PubMed  Google Scholar 

  9. Miyamoto N, Tajima M, Higuchi Y et al (1999) Epidemiological survey for OA of the knee in Japan. Orthopedics 50:1033–1038

    Google Scholar 

  10. Boegard T, Jonsson K (1999) Radiography in OA of the knee. Skeletal Radiol 28:605–615

    Article  CAS  PubMed  Google Scholar 

  11. Sowers M, Lachance L, Hochberg M, Jamadar D (2000) Radiographically defined OA of the hand and knee in young and middle-aged African American and Caucasian women. OA Cartilage 8:69–77

    Article  CAS  Google Scholar 

  12. Felson DT, Naimark A, Anderson JJ, Kazis L, Castelli W, Meeana RF (1987) The prevalence of knee OA in the elderly: the Framingham OA study. Arthritis Rheum 30:914–918

    CAS  PubMed  Google Scholar 

  13. Hart DJ, Doyle DV, Spector TD (1999) Incidence and risk factors for radiographic knee osteoarthritis in middle-aged women: the Chingford study. Arthritis Rheum 42:17–24

    Article  CAS  PubMed  Google Scholar 

  14. Spector TD, Hart DJ (1992) How serious is knee OA? Ann Rheum Dis 51:1105–1106

    CAS  PubMed  Google Scholar 

  15. Felson DT, Zhang Y (1998) An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheum 41:1343–1355

    Article  CAS  PubMed  Google Scholar 

  16. Felson DT, Anderson JJ, Naimark A, Walker AM, Swift M, Meenan RF (1988) Obesity and knee osteoarthritis: the Framingham study. Ann Intern Med 109:18–24

    CAS  PubMed  Google Scholar 

  17. Cicuttini FM, Bake JR, Spector TD (1996) The association of obesity with osteoarthritis of the hand and knee in women: a twin study. J Rheumatol 23:1221–1226

    CAS  PubMed  Google Scholar 

  18. Schipplein OD, Andriacchi TP (1991) Interaction between active and passive knee stabilizers during level walking. J Orthop Res 9:113–119

    CAS  PubMed  Google Scholar 

  19. Denko CW, Boja B, Moskowitz RW (1994) Growth promoting peptides in osteoarthritis and diffuse idiopathic skeletal hyperostosis—insulin, insulin-like growth factor-I, growth hormone. J Rheumatol 21:1725–1730

    CAS  PubMed  Google Scholar 

  20. Anderson JJ, Felson DT (1988) Factors associated with osteoarthritis of the knee in the first national Health and Nutrition Examination Survey (HANES I). Evidence for an association with overweight, race, and physical demands of work. Am J Epidemiol 128:179–189

    CAS  PubMed  Google Scholar 

Download references


The authors would like to express sincere appreciation for the great contributions of the Sankyo Company to this epidemiologic study.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Shun-Le Chen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Du, H., Chen, SL., Bao, CD. et al. Prevalence and risk factors of knee osteoarthritis in Huang-Pu District, Shanghai, China. Rheumatol Int 25, 585–590 (2005).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: