No difference in gender-specific hip replacement outcomes.
Gender-specific total hip arthroplasty (THA) design has been recently debated with manufacturers launching gender-based designs. The purpose of this study was to investigate the survivorship and clinical outcomes of a large primary THA cohort specifically assessing differences between genders in clinical outcomes, implant survivorship, revisions as well as sizing and offset differences. We reviewed 3461 consecutive patients receiving 4114 primary THAs (1924 women, 1537 men) between 1980 and 2004 with a minimum of 2 years followup (mean, 11.33 +/- 6.5 years). A subset of patients with complete implant data was reviewed for sizing and offset differences. Preoperative, latest, and change in clinical outcome scores as well as Kaplan-Meier analysis were performed. Men had higher raw clinical outcome scores preoperatively and postoperatively. Differences in change of clinical outcome scores were found only in the WOMAC pain score in favor of the female cohort (39.4 versus 36.1). Survivorship and revision rate were not significantly different. Men used larger stems with greater stem lengths, neck offset, and neck lengths. Current implant systems were sufficiently versatile to address the different size and offset needs of male and female patients. These data suggest there is no apparent need for a gender-designed THA system.


METHODS
Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
Kostamo
Timothy
T
Division of Orthopaedic Surgery, London Health Sciences Centre, University of Western Ontario, London, ON, Canada.
Bourne
Robert B
RB
Whittaker
John Paul
JP
McCalden
Richard W
RW
MacDonald
Steven J
SJ
D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data*; D005260:Female; D005270:Femur Head / Q000033:anatomy & histology / Q000601:surgery; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D015207:Osteoarthritis, Hip / Q000453:epidemiology* / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D011788:Quality of Life; D020127:Recovery of Function; D017678:Sex Distribution; D016896:Treatment Outcome
Orthopedics. 2006 Sep;29(9):768-9
17004583
J Bone Joint Surg Am. 2002;84-A Suppl 2:2-20
12479335
Clin Orthop Relat Res. 2003 Dec;(417):62-73
14646703
J Bone Miner Res. 2000 Oct;15(10):1992-7
11028452
J Arthroplasty. 2006 Jun;21(4):559-66
16781410
N Engl J Med. 2000 Apr 6;342(14):1016-22
10749964
Med Care. 2002 Jun;40(6):461-70
12021672
Am J Med. 1997 Jun;102(6):524-30
9217666
Arthritis Rheum. 1994 May;37(5):687-94
8185695
Forensic Sci Int. 2005 Jan 29;147(2-3):141-5
15567618
Leg Med (Tokyo). 2003 Mar;5 Suppl 1:S347-50
12935630
Forensic Sci Int. 2000 Sep 11;113(1-3):315-21
10978643
Orthopedics. 2006 Sep;29(9):836-8
17004613
J Bone Miner Res. 2001 Jul;16(7):1291-9
11450705
J Bone Miner Res. 2008 Jan;23(1):121-30
17892375
Bone. 2007 Oct;41(4):722-32
17662680
Bone. 1997 Apr;20(4):365-9
9108357
Osteoporos Int. 1998;8(3):231-9
9797907
Forensic Sci Int. 2005 Jan 29;147(2-3):135-9
15567617