Sex plays a role in orthopaedics
There is no debate that males and females are different, but there has been limited comprehension of the influence of sex on disease.
Osteoarthritis affects more than forty million Americans and more than a quarter of the population between the ages of 45 and 64 years old. The disease is progressive, painful and currently incurable. In a special J. Robert Gladden Society supplement of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), Mary I. O’Connor, MD, associate professor and chair of the Department of Orthopedic Surgery at the Mayo Clinic in Jacksonville, Florida and an Academy Fellow, reviewed the sex differences in osteoarthritis of the hip and knee.
“Osteoarthritis is the leading cause of disability in people ages 65 and older,” said O’Connor. “However, women are more likely than men to suffer from the disease and they experience more severe arthritis in the knee.”
In the review, Dr. O’Connor outlines several risk factors for osteoarthritis:
- Genetics – which affects joint location and wear patterns
- Anatomy – which influences the alignment of the joint
- Prior knee injury – females are at a higher risk for ACL injury
- Obesity – which affects both the development and progression of osteoarthritis
There are also differences in how men and women are diagnosed and treated. “Although the diagnosis of osteoarthritis does not differ between men and women, symptom severity may differ based upon gender. A recent Canadian study found that surgery for hip and knee osteoarthritis is underused by both genders, and that the degree of underuse is three times greater in women,” stated O’Connor.
More research is currently needed to better understand the role these differences play and how they may influence a patient’s decision to proceed with treatment. Future efforts should focus on improving osteoarthritis patient education which may increase the likelihood that appropriate candidates receive treatment or even surgery.
