The prevalence of and demographic factors associated with radiographic knee osteoarthritis in Korean adults aged ≥ 50 years: The 2010–2013 Korea National Health and Nutrition Examination Survey

BACKGROUND: To reduce the social burden of knee osteoarthritis (OA) by addressing it in the early stages in the population at greatest risk, the epidemiology of knee OA needs to be understood and associated demographic factors need to be identified. OBJECTIVES: We evaluated the weighted prevalence of and demographic factors associated with radiographic knee OA in Korean adults. METHODS: We analyzed data from 12,287 individuals aged ≥ 50 years who had radiographs of the knee taken in the 2010–2013 Korea National Health and Nutrition Examination Survey (KNHANES). Radiographic knee OA was defined based on the Kellgren–Lawrence grade, as follows: 0: No abnormal finding 1: Mild degenerative changes, minute osteophytes 2: Mild knee OA, definite osteophytes 3: Moderate knee OA, moderate joint-space narrowing and definite osteophytes 4: Severe knee OA, severe joint-space narrowing with subchondral sclerosis. RESULTS: We found that the prevalence of radiographic knee OA in the Korean adult population was 35.1%. Logistic regression analyses were performed to identify factors associated independently with radiographic knee OA, with age, sex, area of residence, education level, household income, and obesity serving as covariates. Women were at greater risk than men of having knee OA (OR 2.12, 95% CI 1.90–2.37, p < 0.001). Compared with subjects aged 50–59 years, adults aged ≥ 80 years were at 8.87-fold (95% CI 7.12–11.06, p < 0.001) greater risk of having knee OA. Residence in a rural area was associated with a greater risk of having radiographic knee OA than was residence in an urban area (OR 1.26, 95% CI 1.08–1.48, p = 0.004), regardless of knee OA severity (Kellgren–Lawrence grades ≥2, ≥3, and 4). Elementary school graduates had 1.71-fold (p < 0.001) greater risks of having knee OA than did college graduates. Household incomes ≤24th percentile were associated with a greater risk of having knee OA compared with those ≥75th percentile (OR 1.28, 95% CI 1.08–1.52, p = 0.004). Obesity was associated with an approximately two-fold greater risk of knee OA, regardless of knee OA severity (Kellgren–Lawrence grades ≥2, ≥3, and 4). CONCLUSIONS: Using data from the 2010–2013 KNHANES and defining knee OA as Kellgren–Lawrence grade ≥ 2, we found that the prevalence of radiographic knee OA was 35.1% (24.4% in men, 44.3% in women) in a representative sample of Korean adults aged ≥ 50 years, with the highest prevalence (78.7%) observed in women aged ≥ 80 years. Low socioeconomic status and traditional factors, including age, female sex, and obesity, were associated with the risk of knee OA.