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Gender Differences in Total Hip Arthroplasty

Gender Differences in Total Hip Arthroplasty

Research has shown that total hip arthroplasty (THA) can significantly improve function and quality of life and reduce pain. THA has yielded excellent results when assessed at 5 to 7 years after the procedure. Despite these successes, there is still ongoing debate about how certain factors relating to patients, implants, surgeons, procedures, and volume affect THA outcomes. The contribution of each of these types of factors is difficult to evaluate independently. The FDA recently provided guidance for the enrollment of women and for conducting sex-specific analyses in device studies, with an emphasis on transparency. “This is an important issue in orthopedics,” explains Monti Khatod, MD. Sex differences in THA are substantial, and industry has already started developing sex-specific devices. Furthermore, THA is more often performed in women than men. Sex-specific risk factors and outcomes have been investigated for most other major surgical procedures, but Dr. Khatod says it is even more important to understand these differences in THA, especially with the location of the femoral head center, size and shape of the femoral canal, and trabecular patterns. “It’s still unclear how anatomical sex differences can influence functional outcomes and implant survivorship,” he says. “While some studies suggest that men have higher perioperative complication and failure rates, others have observed similar failure rates and functional outcomes among men and women.” Taking a Closer Look At Joint Replacement In a study published in JAMA Internal Medicine, Dr. Khatod and colleagues used a large total joint replacement registry cohort of elective primary THA in 46 hospitals within the United States. The purpose of the analysis was to determine whether sex was associated...
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