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. 2003 Aug;62(8):748–754. doi: 10.1136/ard.62.8.748

Disability in adults with hip and knee arthroplasty: a French national community based survey

I Boutron 1, S Poiraudeau 1, J Ravaud 1, G Baron 1, M Revel 1, R Nizard 1, M Dougados 1, P Ravaud 1
PMCID: PMC1754638  PMID: 12860730

Abstract

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.

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Figure 1.

Figure 1

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The Handicap, Disability, Dependence Survey design.

Figure 2.

Figure 2

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Method used to identify the hip and/or knee arthroplasty group.

Figure 3.

Figure 3

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Percentage of subjects in the arthroplasty population with self reported disability in various activities.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Badley E. M., Rasooly I., Webster G. K. Relative importance of musculoskeletal disorders as a cause of chronic health problems, disability, and health care utilization: findings from the 1990 Ontario Health Survey. J Rheumatol. 1994 Mar;21(3):505–514. [PubMed] [Google Scholar]
  2. Callahan C. M., Drake B. G., Heck D. A., Dittus R. S. Patient outcomes following tricompartmental total knee replacement. A meta-analysis. JAMA. 1994 May 4;271(17):1349–1357. [PubMed] [Google Scholar]
  3. Charnley J. The long-term results of low-friction arthroplasty of the hip performed as a primary intervention. 1972. Clin Orthop Relat Res. 1995 Oct;(319):4–15. [PubMed] [Google Scholar]
  4. Courpied J. P., Caton J., Bouee S., Charpak Y., Thomine J. M. Pathologie ostéo-articulaire de l'adulte en France. Enquête auprès d'un énchantillon de 2000 personnes. Rev Chir Orthop Reparatrice Appar Mot. 2001 Sep;87(5):424–436. [PubMed] [Google Scholar]
  5. Fortin P. R., Clarke A. E., Joseph L., Liang M. H., Tanzer M., Ferland D., Phillips C., Partridge A. J., Bélisle P., Fossel A. H. Outcomes of total hip and knee replacement: preoperative functional status predicts outcomes at six months after surgery. Arthritis Rheum. 1999 Aug;42(8):1722–1728. doi: 10.1002/1529-0131(199908)42:8<1722::AID-ANR22>3.0.CO;2-R. [DOI] [PubMed] [Google Scholar]
  6. Franzén H., Johnsson R., Nilsson L. T. Impaired quality of life 10 to 20 years after primary hip arthroplasty. J Arthroplasty. 1997 Jan;12(1):21–24. doi: 10.1016/s0883-5403(97)90042-5. [DOI] [PubMed] [Google Scholar]
  7. Harris W. H., Sledge C. B. Total hip and total knee replacement (1). N Engl J Med. 1990 Sep 13;323(11):725–731. doi: 10.1056/NEJM199009133231106. [DOI] [PubMed] [Google Scholar]
  8. Harris W. H., Sledge C. B. Total hip and total knee replacement (2) N Engl J Med. 1990 Sep 20;323(12):801–807. doi: 10.1056/NEJM199009203231206. [DOI] [PubMed] [Google Scholar]
  9. Havelin L. I., Engesaeter L. B., Espehaug B., Furnes O., Lie S. A., Vollset S. E. The Norwegian Arthroplasty Register: 11 years and 73,000 arthroplasties. Acta Orthop Scand. 2000 Aug;71(4):337–353. doi: 10.1080/000164700317393321. [DOI] [PubMed] [Google Scholar]
  10. Hawker G., Wright J., Coyte P., Paul J., Dittus R., Croxford R., Katz B., Bombardier C., Heck D., Freund D. Health-related quality of life after knee replacement. J Bone Joint Surg Am. 1998 Feb;80(2):163–173. doi: 10.2106/00004623-199802000-00003. [DOI] [PubMed] [Google Scholar]
  11. Herberts P., Malchau H. Long-term registration has improved the quality of hip replacement: a review of the Swedish THR Register comparing 160,000 cases. Acta Orthop Scand. 2000 Apr;71(2):111–121. doi: 10.1080/000164700317413067. [DOI] [PubMed] [Google Scholar]
  12. Jones C. A., Voaklander D. C., Johnston D. W., Suarez-Almazor M. E. Health related quality of life outcomes after total hip and knee arthroplasties in a community based population. J Rheumatol. 2000 Jul;27(7):1745–1752. [PubMed] [Google Scholar]
  13. KATZ S., FORD A. B., MOSKOWITZ R. W., JACKSON B. A., JAFFE M. W. STUDIES OF ILLNESS IN THE AGED. THE INDEX OF ADL: A STANDARDIZED MEASURE OF BIOLOGICAL AND PSYCHOSOCIAL FUNCTION. JAMA. 1963 Sep 21;185:914–919. doi: 10.1001/jama.1963.03060120024016. [DOI] [PubMed] [Google Scholar]
  14. Kirwan J. R., Currey H. L., Freeman M. A., Snow S., Young P. J. Overall long-term impact of total hip and knee joint replacement surgery on patients with osteoarthritis and rheumatoid arthritis. Br J Rheumatol. 1994 Apr;33(4):357–360. doi: 10.1093/rheumatology/33.4.357. [DOI] [PubMed] [Google Scholar]
  15. LaPlante M. P. The demographics of disability. Milbank Q. 1991;69 (Suppl 1-2):55–77. [PubMed] [Google Scholar]
  16. Nilsdotter A. K., Aurell Y., Siösteen A. K., Lohmander L. S., Roos H. P. Radiographic stage of osteoarthritis or sex of the patient does not predict one year outcome after total hip arthroplasty. Ann Rheum Dis. 2001 Mar;60(3):228–232. doi: 10.1136/ard.60.3.228. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Rissanen P., Aro S., Sintonen H., Slätis P., Paavolainen P. Quality of life and functional ability in hip and knee replacements: a prospective study. Qual Life Res. 1996 Feb;5(1):56–64. doi: 10.1007/BF00435969. [DOI] [PubMed] [Google Scholar]
  18. Rissanen P., Aro S., Slätis P., Sintonen H., Paavolainen P. Health and quality of life before and after hip or knee arthroplasty. J Arthroplasty. 1995 Apr;10(2):169–175. doi: 10.1016/s0883-5403(05)80123-8. [DOI] [PubMed] [Google Scholar]
  19. Ritter M. A., Albohm M. J., Keating E. M., Faris P. M., Meding J. B. Comparative outcomes of total joint arthroplasty. J Arthroplasty. 1995 Dec;10(6):737–741. doi: 10.1016/s0883-5403(05)80068-3. [DOI] [PubMed] [Google Scholar]
  20. Salmon P., Hall G. M., Peerbhoy D., Shenkin A., Parker C. Recovery from hip and knee arthroplasty: Patients' perspective on pain, function, quality of life, and well-being up to 6 months postoperatively. Arch Phys Med Rehabil. 2001 Mar;82(3):360–366. doi: 10.1053/apmr.2001.21522. [DOI] [PubMed] [Google Scholar]
  21. Schulte K. R., Callaghan J. J., Kelley S. S., Johnston R. C. The outcome of Charnley total hip arthroplasty with cement after a minimum twenty-year follow-up. The results of one surgeon. J Bone Joint Surg Am. 1993 Jul;75(7):961–975. doi: 10.2106/00004623-199307000-00002. [DOI] [PubMed] [Google Scholar]
  22. Seagroatt V., Tan H. S., Goldacre M., Bulstrode C., Nugent I., Gill L. Elective total hip replacement: incidence, emergency readmission rate, and postoperative mortality. BMJ. 1991 Dec 7;303(6815):1431–1435. doi: 10.1136/bmj.303.6815.1431. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Söderman P., Malchau H., Herberts P., Johnell O. Are the findings in the Swedish National Total Hip Arthroplasty Register valid? A comparison between the Swedish National Total Hip Arthroplasty Register, the National Discharge Register, and the National Death Register. J Arthroplasty. 2000 Oct;15(7):884–889. doi: 10.1054/arth.2000.8591. [DOI] [PubMed] [Google Scholar]
  24. Söderman P., Malchau H., Herberts P. Outcome after total hip arthroplasty: Part I. General health evaluation in relation to definition of failure in the Swedish National Total Hip Arthoplasty register. Acta Orthop Scand. 2000 Aug;71(4):354–359. doi: 10.1080/000164700317393330. [DOI] [PubMed] [Google Scholar]
  25. Towheed T. E., Hochberg M. C. Health-related quality of life after total hip replacement. Semin Arthritis Rheum. 1996 Aug;26(1):483–491. doi: 10.1016/s0049-0172(96)80029-1. [DOI] [PubMed] [Google Scholar]
  26. Verbrugge L. M., Lepkowski J. M., Imanaka Y. Comorbidity and its impact on disability. Milbank Q. 1989;67(3-4):450–484. [PubMed] [Google Scholar]

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