OBJECTIVES: Recent trends in the number of primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) in the US has suggested a massive future demand for THA and TKA. It is unknown if this trend is the same in France as France has a slower growth rates in obesity compared to US. The purpose of our study was to describe the recent trend of primary THA and TKA in France. METHODS: Registry data on THA and TKA, collected between 2000 and 2006, were obtained from the Agence technique de l'information sur l'hospitalisation (ATIF 2009). RESULTS: In 2006, approximately 139,000 hip replacements and 66,000 knee replacements were performed in France. Hip procedures increased by 6% and knee procedures by 30 % since 2001. The economic burden associated with joint replacements is estimated approx. 2 billion Euro in 2006. The mean cost for primary hip replacement in France was €7,467 in 2006 and €8,690 for knee replacement procedures. Arthroplasties represent the medical specialty with the highest expenses in France. In France, only 41% of knee replacements were cemented. This proportion is relatively low in comparison to others European countries. CONCLUSIONS: This trend could accelerate in the near future due to changes in French demographics: increase of prevalence of overweight and obese patients as well as population ageing. These two categories of population have the highest incidence of joint replacement procedures. Obesity prevalence increases by 5 % every year since 1997 to reach 12.4% of the total population in 2006 and the elderly population will reach 30 % of the French population by 2050. In the context of the current financial crisis reducing unnecessary health care expenditure is inevitable. In the French market implant price represent 30% of hip replacement procedure and 38 % for knee replacement.