Osteoarthritis: Women in France are not requesting the help they need

Surgery for advanced osteoarthritis of the knee is less likely to be offered to women than men, statistics from the French National Health Data System (SNDS) show.

It found that between 2009 and 2019, total knee replacement procedures increased by 73% in men (82% in those under 65), compared to 46% in women (53% in those under 65).

Women are, on average, twice as likely as men to suffer from knee osteoarthritis, yet only 63% of prostheses fitted each year are for women, Le Figaro reported in January.

What is osteoarthritis?

Osteoarthritis occurs because of a breakdown in cartilage, the rubbery connective tissue covering the ends of the bones in your joints. 

It is most likely to occur in the spine, knee, hip and hand, restricting movement and causing pain; depending on its severity it can become a disability. It cannot be eradicated, but you can treat the symptoms.

What causes osteoarthritis?

Researchers do not know what triggers the breakdown of the tissues in a joint, but as osteoarthritis progresses, it can damage the tendons, ligaments and bone, which may become misshapen. 

While 70% of sufferers are aged 55 or older, it can affect any age, and some patients have a history of joint injury or overuse. 

You are at increased risk if you have a family history or if you are overweight, as it adds pressure to the joints.

Can I treat it myself?

Maintaining a healthy weight is a prevention as well as treatment, along with reasonable weight-bearing exercise to strengthen muscles. 

If joints are already painful, you can apply heat pads or ice packs depending on which works best for you, and some swear by massage using essential oils.

When do I need to see a doctor?

Consult your GP if you notice that a joint is painful, swollen, less flexible, stiff (especially after resting), or if it begins to click or pop. 

If osteoarthritis shows on an X-ray but it is not causing pain, then healthcare system Ameli warns that no treatment will be required. 

Read more: Healthcare: What's new in France in 2025

What are the likely treatments?

You will probably be offered pain relief or anti-inflammatories, often as a gel that you can apply directly to the affected area. 

We would refer to these as NSAIDs (non-steroidal anti-inflammatory drugs), or AINS in French. For persistent pain, you could be prescribed une infiltration. This is an injection, usually of cortisone, to calm inflammation and reduce pain in the affected joint. 

A little uncomfortable but not painful, the injection is highly effective, easing pain for several weeks, and can be redone up to three times a year, costing around €100, generally covered by your health insurance. 

Some patients prefer acupuncture sessions or cures thermales (seawater spa treatments, often residential over several days) although these are not always refunded by your insurance.

Severe cases of osteoarthritis require joint-replacement surgery to ease pain and allow you to regain your mobility. 

Particularly common for hips and knees, this surgery is usually covered by the French health system (sécurité sociale plus your health insurance), but check beforehand as an operation can cost several thousand euros.

Read more: How are patients affected by the new rise in doctors’ fees in France?

Helpful organisations

The Ameli website offers advice based on the joint affected, for example, knee or hip, while you can find more general information and statistics from the World Health Organization.

Quick facts:

1. 60% of osteoarthritis sufferers are female
2. Between 1990 and 2019, osteoarthritis cases worldwide increased by 113%
3. The knee accounts for 70% of osteoarthritis cases 
4. According to Ameli, only 3% of the population under 45 has osteoarthritis; in the 65+ age-group this rises to 65%, and aged 80 or over it rises to 80%.