Sex-based differences in the outcomes of total hip and knee arthroplasty: a narrative review

ANZ J Surg. 2021 Apr;91(4):553-557. doi: 10.1111/ans.16299. Epub 2020 Sep 21.

Abstract

Total joint arthroplasty (TJA) is an effective treatment for end-stage osteoarthritis, which aims to alleviate pain and improve function and mobility. Despite the remarkable success of TJA, complications can arise, leading to unplanned hospital readmission, implant failure, morbidity and mortality. Recently, there has been a growing interest in analysing sex-based differences in diseases and response to medical interventions. This review summaries evidence pertaining to the widening gap between men and women regarding the utilization and outcome of TJA surgery. Interactions between sex and patient-reported outcome, implant failure and medical complication are complex and often demonstrate conflicting results. Significantly, there is a global consensus that men are at a higher risk of developing prosthetic joint infection following joint arthroplasty. Guided by the literature, there is a clear need for standardized methods of collecting, analysing and reporting sex-specific data to improve outcomes for both men and women who undergo TJA.

Keywords: orthopaedic surgery; sex difference; total joint arthroplasty.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Arthroplasty, Replacement, Hip* / adverse effects
  • Arthroplasty, Replacement, Knee* / adverse effects
  • Female
  • Humans
  • Male
  • Osteoarthritis*
  • Patient Readmission
  • Treatment Outcome