Study Refutes Gender Differences Data

A common conception about women having joint replacement surgery has been that fewer surgeries were performed on women because they tended to fare worse than men afterward.

That idea has been contradicted by a new study led by Bheeshma Ravi, M.D., Ph.D. of the University of Toronto who analyzed data from patients who had their first total knee (TKR) or total hip replacement (THR) between 2002 and 2009. They found that while men tend to have their first total joint replacement at a younger age than did women, men were more likely to have complications or need revision surgery at a later date.

The data covered nearly 38, 000 total hip replacements, 54% of which were in women, and nearly 60, 000 total knee replacements, of which 60% were in women. Among the total hip replacements, female patients were significantly older than were the male patients (70 versus 65 years). Among the total knee replacements there was no significant age difference. The median was 68 years of age for both genders.

After surgery, men were 15% more likely to return to the emergency department within 30 days of hospital discharge following either THR or TKR, and were 50% more likely than women to require a revision arthroplasty within two years of their TKR.

“Despite the fact that women have a higher prevalence of advanced hip and knee arthritis, prior research indicates that North American women with arthritis are less likely to receive joint replacement than men, ” said Ravi. “One possible explanation is that women are less often offered or accept surgery because their risk of serious complications following surgery is greater than that of men.”

This study found that while overall rates of serious complications were low for both groups, they were lower for women than for men for both hip and knee replacement. “Thus, the previously documented sex difference utilization of TJR cannot be explained by differential risks of complications following surgery, ” Ravi said.