Women Demonstrate More Pain and Worse Function Before THA but Comparable Results 12 Months After Surgery

Abstract

Background Many studies report differences in patientreported outcome measures (PROMs) for men and women undergoing total hip arthroplasty (THA). Few studies have evaluated whether these are explained by corresponding differences in important preoperative factors. Questions/purposes (1) Are there differences between men and women in PROM scores preoperatively and 12 months after THA? (2) Do baseline differences in comorbidity, age, body mass index (BMI), and mental health status explain these differences in PROM scores? Methods Preoperatively, 300 patients completed the Oxford Hip Score (OHS), WOMAC, and SF-12; 261 (86%) of them (129 women, 64 ± 11 years; 132 men, 66 ± 10 years) completed the same questionnaires 12 months postoperatively and also rated the acceptability of their current symptoms and change in general health. Results Preoperatively, women showed worse scores than men in the OHS (À1.9; 95% confidence interval, À3.6 to À0.3) and WOMAC (À6.3; À10.9 to À1.7). At 12 months postoperatively, the absolute scores for all PROMs were not significantly different. After controlling for BMI, age, comorbidity, SF-12 mental health scores, and sociodemographic characteristics, the baseline differences remained. Conclusions Surgeons may be more reluctant to operate on women than men because they perceive that, because of their worse baseline status, women are likely to have worse outcomes; however, given that we found no evidence for differences in patient-reported outcomes at 12 months, these suspicions would appear to be unfounded. Women and men can be expected to benefit to a similar extent from THA. Level of Evidence Level III, therapeutic study.

Health-Related Quality of Life in Outpatient Parenteral Antimicrobial Therapy

“…Female sex was a risk factor for a lower MCS-12. This has been shown in other studies as well, including among women undergoing total hip arthroplasty [ 11 ]. This may also be impacted by fewer caregivers present for women than for men.…”

Sex-Based Differences in Patient-Reported Outcomes After Arthroscopic Rotator Cuff Repair

“…Several studies have demonstrated that female patients have significantly worse preoperative functional outcome scores before total hip arthroplasty. 13,23 Mannion et al 20 evaluated pain and function 1 year after total hip arthroplasty and found that female patients had significantly lower baseline functional outcome scores. However, the authors noted no significant sex differences in outcome scores at 1-year follow-up.…”

The impact of age and preoperative health-related quality of life on patient-reported improvements after total hip arthroplasty

“…Sex, age, and preoperative quality of life are factors that appear to have an effect on patient reported outcomes after surgery. 5 – 9 In addition, conditions such as pain, 5 function, 10 , 11 comorbidity, 12 , 13 BMI, 14 – 16 and underlying diseases prior to the operation 17 , 18 seem to play a role. Furthermore, expectations before surgery 4 , 19 , 20 and socioeconomic status 21 , 22 may influence patients’ reporting postoperatively.…”