OA is an age-related condition and one of the most important causes of pain and disability in older people. However, the difference between physiologic aging of the cartilage and OA cartilage is not clear. Although radiographic evidence of OA is universal in at least some joints in people over the age of 60 years, significant symptomatic disease probably affects only about 10-20 percent of the population.95 OA of the knee affects function in 10 percent of the population aged over 50, with the female-male ratio being 3:1.96 OA of the hip is less common but is more likely to cause disability, with the prevalence increasing from less than 3 percent under the age of 65 through to 5 percent of people in their eighties.

OA is common worldwide, but the sites most commonly affected vary in different populations. Nodal OA of the hand is rare in black Africans and Malaysians, and OA of the hip is uncommon in black and Asian populations compared with white people.97 These ethnic differences seem to reflect genetic rather than cultural factors.

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