Women Recover Faster Than Men after Standard Knee Arthroplasty

Abstract

Background Specific anatomic differences are believed to account for gender-specific function and health-related quality of life after TKA. However, there are conflicting data in the literature regarding these gender-specific outcomes, especially as woman appear to have surgery later in the course of the disease compared with men. Questions/purposes We asked whether (1) women had worse knee function and health-related quality of life after TKA compared with men, (2) lower improvements in scores, and (3) slower recovery after surgery. Methods Using a cohort study design, we retrospectively analyzed prospectively collected data from three multicenter randomized controlled trials evaluating rehabilitation measures after standard unisex knee arthroplasty in 494 patients (141 men and 353 women). The primary outcome was selfreported physical function as measured by the WOMAC at 3, 6, 12, and 24 months after surgery. Secondary outcomes included the pain and stiffness scales of the WOMAC and the physical and mental component summaries of the SF-36. At the time of surgery, the women were on average older (70.8 versus 67.8 years), had lower mean physical function (55 versus 47), higher mean pain scores (54 versus 48), and greater stiffness (54 versus 46) as measured by the WOMAC. Results At the 3-, 6-, 12-, and 24-month followups, men and women had similar WOMAC scores. Improvements were greater for women compared with men for WOMAC 123Clin Orthop Relat Res (2011) 469:2855-2865 DOI 10.1007/s11999-011-1921 function and pain subscale scores at the 3-month (function, 28 versus 23; pain, 32 versus 25) and 6-month followups (function, 32 versus 27; pain, 36 versus 31). At the 12-and 24-month followups we noted no differences in improvement between men and women. Conclusion Although women had greater functional limitations at the time of surgery than men, they recover faster early after standard TKA although function is similar at 12 and 24 months. Women also had greater improvement of WOMAC scores after standard TKA than men. Level of Evidence Level II, prognostic study. See the guidelines for authors for a complete description of levels of evidence.

Clinical improvement and satisfaction after total joint replacement: a prospective 12-month evaluation on the patients’ perspective

“…There is conflicting evidence if women recover faster than men after TKA [34]. We could not find any significant effect of gender, age and BMI on PROM values and satisfaction ratings for both THA and TKA patients.…”

“…THA patients showed the greatest improvements within the first 3 months, while TKA patients continuously improved over time. A similar observation was made by Liebs and coworkers who showed continuous improvements in WOMAC and SF-36 values over 24 months after TKA [34]. Likewise, Papakostidou et al [35] pointed out that large functional improvements will be achieved between 6 weeks and 3 months after TKA, but further improvements were seen up to 1 year postoperatively.…”

A Prospective, Longitudinal Study of Outcomes Following Total Knee Arthroplasty Stratified by Gender

“…The literature we evaluated seems to largely support our findings in this study (Table 2). However, not all studies, which analyzed gender showed a difference in functional outcomes following TKA [21].…”

Comparison of patient reported outcomes after Triathlon® and Kinemax Plus prostheses

“…However, an absence of clinically significant sex differences for WOMAC ® pain and function from one year following surgery has been demonstrated. 26,28 Kennedy et al suggest similarities exist in rates of recovery following TKR between men and women 29 although faster recovery in women in the first six months following TKR (measured by WOMAC ® pain and function) has been reported more recently 30 …”