Global burden-integrated analysis of osteoarthritis research-to-translation dynamics, 1999–2023

Background: Osteoarthritis (OA) is a leading cause of global disability, yet the temporal relationship between disease burden and research and translational activity has not been systematically examined using an integrated, system-level framework. Methods: We conducted a retrospective, system-level analysis of osteoarthritis (OA) research and disease burden from 1999 to 2023. Annual global OA burden estimates (prevalence, YLDs, and DALYs) were obtained from the Global Burden of Disease framework and harmonized with year-wise data on OA publications, experimental model use, interventional clinical trials, and funding acknowledgements derived from PubMed and ClinicalTrials.gov. Publication domains were classified using predefined, rule-based queries applied to metadata fields. Temporal trends, proportional composition, and burden–research scaling relationships were evaluated using descriptive regression and proportion-based analyses. Results: Between 1999 and 2023, global osteoarthritis (OA) disability-adjusted life years (DALYs) approximately doubled, while annual OA publication volume increased more than fourfold. Log–log regression indicated elastic scaling of research output relative to DALYs (β > 1), reflecting disproportionate growth in publication activity. In contrast, interventional clinical trial initiation peaked in the late 2000s and declined in recent years, with trial activity representing a consistently small fraction of total OA publications. Human-relevant experimental approaches constituted a modest and relatively stable proportion of OA research over time. Lag-association analyses demonstrated strong temporal co-trending between DALYs and total publications, moderate alignment for human-relevant research, and weaker associations for clinical trial activity. Conclusion: Over 1999–2023, osteoarthritis research activity expanded substantially relative to disease burden, while downstream clinical translation and adoption of human-relevant approaches remained comparatively limited.