Social and personal consequences of disability in adults with hip and knee arthroplasty. A French national community based survey.
OBJECTIVE
To describe and compare participation restrictions and environmental factors of persons with and without hip or knee arthroplasty in a national community based survey: the Handicap, Disability, Dependence Survey.


METHODS
During the 1999 French Census, a screening questionnaire was proposed to 417,500 persons, for which the response rate was 86%. A stratified random sample with an overrepresentation of disabled persons was performed to constitute the selected population. A computer assisted interview was proposed to 21,760 persons, with a 78% response rate. Chronic conditions, impairment, disability, participation restrictions, and the description of environmental factors were ascertained from the subjects' reports.


RESULTS
The hip and knee arthroplasty group was estimated at 691,000 persons in the French population. Although reporting a higher level of disability, this population did not report more participation restrictions than the general population in terms of their economic situation, housing, social relationships, and holidays. Moreover, when comparing environmental factors, this population reported better housing accessibility, more assistive devices (OR 5.2, 95% CI 3.7-7.2), specific fittings (OR 2.9, 95% CI 2.0-4.2), and helpers (OR 1.8, 95% CI 1.3-2.5). These environmental factors may have compensated for the higher level of disability. Nevertheless, individuals with hip and knee arthroplasty reported more disadvantages when moving within their environment (OR 2.1, 95% CI 1.5-2.9).


CONCLUSIONS
This study provides a detailed description based on a national random sample of participation restrictions and environmental factors of adults with hip and knee arthroplasty.
Boutron
Isabelle
I
National Institute of Statistics and Economic Studies (INSEE), Paris, France.
Poiraudeau
Serge
S
Ravaud
Philippe
P
Baron
Gabriel
G
Revel
Michel
M
Nizard
Remy
R
Dougados
Maxime
M
Ravaud
Jean-François
JF
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D003154:Community Medicine; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires