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1 Département de Médecine Physique et de Réadaptation, Hôpital Cochin (AP-HP), Université R Descartes, 75014 Paris, France
2 INSERM U502, CERMES, 75019 Paris, France
3 Département d’Epidémiologie, Biostatistique et de Recherche Clinique, Groupe hospitalier Bichat-Claude Bernard (AP-HP), Université X Bichat, 75018 Paris, France
4 Service d’Orthopédie, Hôpital Lariboisiére (AP-HP), Université D Diderot, 75010 Paris, France
5 Service de Rhumatologie, Hôpital Cochin (AP-HP), Université R. Descartes, 75014 Paris, France
6 Réseau Fédératif de Recherche sur le Handicap, IFR 25, France
Correspondence to:
Correspondence to:
Dr S Poiraudeau, Service de Rééducation et de Réadaptation de l’Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, 27 rue du Faubourg St Jacques, 75679, Paris cedex 14, France;
serge.poiraudeau{at}cch.ap-hop-paris.fr
Objectives: To compare levels of disability of people with and without hip and knee arthroplasty in a random national sample.
Methods: In 1999 a screening questionnaire to classify people into groups of increasing probabilities of disability was sent to 417 500 people; response rate 86%. The study population was obtained by a stratified randomisation, with a high sampling rate for the most severely disabled group and a minimum sampling rate for people without daily living restrictions. A computer assisted interview to assess levels of disability, dependence, and handicap was given to 21 760 people; response rate 78%. A weighting factor was applied to obtain estimates representative of the French population. The presence of chronic conditions, impairments, and disability was ascertained from the subjects’ reports.
Results: The hip and knee arthroplasty group comprised 815 subjects in the sample, indicating an estimated 691 000 subjects (95% confidence interval (CI) 597 000 to 785 000) in the French non-institutionalised population. The prevalence of arthroplasty is estimated at 1.2%. After adjustments for confounding factors, activity limitations were greater among subjects with arthroplasty for the following activities: climbing stairs (odds ratio (OR)=4.0, 95% CI 2.8 to 5.8); walking distance (OR=3.4, 95% CI 2.5 to 4.6 for a walking distance less than 500 m); bending forward (OR=3.2, 95% CI 2.2 to 4.7); cutting toenails (OR=2.8, 95% CI 1.9 to 3.9); carrying (OR=2.6, 95% CI= 1.8 to 3.8); shopping (OR=2.1, 95% CI 1.5 to 2.9).
Conclusions: This study would be useful to policy-makers considering population strategies for managing disabling arthritis.
Keywords: epidemiology; disability; arthroplasty; hip; knee
This article has been cited by other articles:
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  C. Jinks, K. Jordan, and P. Croft Osteoarthritis as a public health problem: the impact of developing knee pain on physical function in adults living in the community: (KNEST 3) Rheumatology, May 1, 2007; 46(5): 877 - 881. [Abstract] [Full Text] [PDF]
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 L. Linsell, J. Dawson, K. Zondervan, P. Rose, A. Carr, T. Randall, and R. Fitzpatrick Pain and overall health status in older people with hip and knee replacement: a population perspective J. Public Health Med., September 1, 2006; 28(3): 267 - 273. [Abstract] [Full Text] [PDF]
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 C Jinks, M Lewis, and P Croft Health status after hip or knee arthroplasty Ann Rheum Dis, August 1, 2003; 62(8): 700 - 701. [Full Text] [PDF]
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