[Osteoarticular disease in adults in France. A survey of 2000 persons]

Seeking for a global epidemiology data on bone and joint disease in adults in France, we analyzed the problems related to bone and joint disease in a sample population to determine healthcare needs. We also examined patient referral and demand for surgical care for bone and joint disease and the degree of patient satisfaction.

A telephone interview was conducted in a randomly sampled population of adults living in France to determine their demographic characteristics and bone and joint conditions and surgical care reported by the interviewees. Before standardizing, the sample population in the 60-year and older group was increased in order to obtain more precise information concerning degenerative joint disease. The sample included 1000 persons aged under 60 years and another 1000 persons aged over 60 years. The sample populations were matched to the French population for sex and age distribution. One hundred personal face-to-face interviews were also conducted with 100 persons residing in a nursing home. The two surveys were conducted in June and July 1999.

Extrapolation of the data obtained to the French population yielded a total of 12 million adults affected by a bone and joint condition during the year preceding the survey. Considering both study samples, the most frequent localizations concerned the spine and the knees. The distribution of the other localizations was age and sex dependent. The percentage of trauma-induced conditions was 31%, predominantly in men under the age of 60 years and in institutionalized individuals. Extrapolation yielded a total of 5.4 million persons who had (or expected to have) a surgical intervention due to a bone and joint condition. The percentage of surgical treatment was highest for fractures (41%) and extravertebral osteoarthritis (18%). Extrapolation to the French population yielded 0.55 million persons aged over 60 years with a hip prosthesis and 0.27 million with a knee prosthesis. Seventy-six percent of the individuals who had undergone surgery for a conditions unrelated to trauma felt their quality of life had been improved. For those who had surgery for a trauma-induced condition, 85% considered they had minimal or no sequelae. Information provided by the surgeon concerning surgical care was thought to be insufficient by 23% of the operated individuals and 43% of those who had a joint prosthesis stated they had not been informed that their implant might be changed. Management of postoperative pain was thought to be insufficient by 36% of the operated individuals.

Due to the wide field of investigation and the methodology used to collect these data, our findings cannot be easily compared with other epidemiological data. They must be considered with caution due to the sampling bias of a telephone interview and also to the bias introduced by the simplified nosology scheme used for the questionnaire and the fact that no medical validation was performed. These data do however show that a large number of adults are concerned, notwithstanding conditions occurring before the age of 18 years with the frequency of accidents during childhood and adolescence. The data collected confirm the priorities set within the framework of the Bone and Joint Decade 2000-2010.