Joint Replacement Surgery & Gender

Since the first experiments more than a century ago, joint replacement surgery has become one of the most successful orthopedic procedures in the world, bringing relief and renewed capability to thousands of patients every year—especially arthritis patients. In the United States, most hip and knee replacements are done because of arthritis.

Studies, however, have found one curious statistic: Although women tend to have more advanced arthritis in the knees and hips, they are less likely to have joint replacement surgery. Why might this be? One possible explanation could be that physicians believe that women have a greater risk of complications after joint replacement surgery.

Recently, Canadian researchers examined whether men and women fare differently after joint replacement surgery. The researchers analyzed data from patients who went to a hospital in Ontario for either a first total knee replacement or a first total hip replacement. The number of joint replacements totaled almost 38,000. The women who received hip replacements were somewhat older than the male patients (70 versus 65), but there was no significant age difference with knee replacement patients (the median age, both male and female, was 68).

Somewhat surprisingly, the researchers discovered that the male patients, not the female ones, were more likely to have complications after total joint replacement surgery; specifically, their analysis found that men were 15% more likely to visit the emergency room in the month following surgery. Men were more likely to have a heart attack in the three months after surgery, and they were 50% more likely to require revision surgery in the two years after their operations. The overall rates of serious complications after surgery were low for both men and women, but the rates were lower for women than for men.

The researchers hope that further studies will shed light on why men have more complications after joint replacement therapy than women do. Until then, at least we know that surgery for women need not be avoided for fear of a greater risk of complications.

This column is written by Joseph Gustaitis, a freelance writer and editor in the Chicago area.

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