Bone and joint disease in adults in France: a survey in 2000 persons

Purpose of the study 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 de gree of patient satisfaction. Material and methods, A telephone interview was conducted in a randomly sampled population of adu lts living in France to determine their demographic characteristics and bon e and joint conditions and surgical care reported by the interviewees. Befo re standardizing, the sample population in the 60-year and older group was increased in order to obtain more precise information concerning degenerati ve joint disease. The sample included 1000 persons aged under 60 years and another 1000 persons aged over 60 years. The sample populations were matche d to the French population for sex and age distribution. One hundred person al 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. Results 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 yea r preceding the survey. Considering both study samples, the most frequent l ocalizations concerned the spine and the knees. The distribution of the oth er localizations was age and sex dependent. The percentage of trauma-induce d conditions was 31 %, predominantly in men under the age of 60 years and i n institutionalized individuals. Extrapolation yielded a total of 5.4 milli on persons who had (or expected to have) a surgical intervention due to a b one and joint condition. The percentage of surgical treatment was highest f or fractures (41 %) and extravertebral osteoarthritis (18 %. Extrapolation to the French population yielded 0.55 million persons aged over 60 years wi th a hip prosthesis and 0.27 million with a knee prosthesis. Seventy-six pe rcent of the individuals who had undergone surgery for a conditions unrelat ed to trauma felt their quality of life had been improved. For those who ha d surgery for a trauma-induced condition, 85 % considered they had minimal or no sequelae. Information provided by the surgeon concerning surgical car e 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 th at their implant might be changed. Management of postoperative pain was tho ught to be insufficient by 36 % of the operated individuals. Discussion Due to the wide field of investigation and the methodology used to collect these data, our findings cannot be easily compared with other epidemiologic al 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 noso logy scheme used for the questionnaire and the fact that no medical validat ion was performed. These data do however show that a large number of adults are concerned, notwithstanding conditions occurring before the age of 18 y ears 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.