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).

Conclusion: 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.