Prevalence of knee radiographic and symptomatic osteoarthritis and ultrasound features across sex and body mass index groups: The Johnston County Health Study
Authors' conclusion
KOA prevalence continues to increase in the population. Sex and BMI differences in KOA prevalence and US features were most pronounced among females with severe obesity.
Study context
- Population
- General population, Johnston County Health Study (2019–2024); 67% female, 66% non-Hispanic white, mean age 55 years, BMI 33 kg/m²
- Participants
- 902 participants
- Exposure
- Prevalence by sex and BMI category
- Outcome
- Weighted prevalence of Ksx, rKOA (KL grade ≥2 or total knee replacement (TKR)), sxKOA (rKOA and Ksx in same knee), severe rKOA (grades 3-4 or TKR) and US features, overall and by sex and BMI
Methodological detailspopulation-based, weighted prevalence estimates
- Population-based
- Weighted prevalence estimates
Main finding
As reported in the abstract
Weighted prevalence, overall
Ksx
61%
Radiographic KOA (rKOA)
36%
sxKOA
27%
Severe rKOA
21%
Observational data: associations, not effects.
Further findings
Prevalence by sex and BMI
- Ksx, rKOA, sxKOA and severe rKOA higher among females and those with obesity
- Severe vs obesity (females): higher prevalence of all radiographic outcomes at moderate and severe grades, non-overlapping CI
Ultrasound (US) features by sex and BMI
- US effusion and synovitis more prevalent in males; medial and lateral cartilage damage more common in females
- With increasing obesity, osteophytes and medial cartilage damage more prevalent, greyscale effusion less frequent
Original publication
Prevalence of knee radiographic and symptomatic osteoarthritis and ultrasound features across sex and body mass index groups: The Johnston County Health Study. Osteoarthritis Cartilage. Published 1 September 2026. doi:10.
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