Women fare better than men following total knee and hip replacement
A new study looking for the first time at gender differences in surgical outcomes has contradicted the idea that total joint replacement surgery is not performed as often in women because they tend to fare worse than men afterwards.
Researchers led by Bheeshma Ravi (University of Toronto) analysed data from patients who attended an Ontario hospital for a first total knee or total hip replacement between 2002 and 2009. They found that while men tend to have their first total joint replacement at a younger age than women, they are 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, 60% in women. Among the total hip replacements, female patients were significantly older than male patients (70 vs 65 years), while among the total knee replacements there was no significant age difference (median was 68 years for both sexes). More of the women who had total joint replacements were classed as frail compared with the men (6.6% vs. 3.5% respectively in the total hip replacements, and 6.7% versus 4.0% in the total knee replacements).
After surgery, men were 15 per cent more likely to return to the emergency department within 30 days of hospital discharge following either THR or TKR, and 50 per cent more likely to require a revision arthroplasty within two years of 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 […] In this study, we 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, particularly the latter,” he continued. “Thus, the previously documented sex difference utilisation of TJR cannot be explained by differential risks of complications following surgery.”
The authors presented their findings at the 2015 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) held in Las Vegas in March.
Source: www.medicalxpress.com and Medical News Today
