Influence of gender on age of treatment with TKA and functional outcome.
BACKGROUND
Previous studies suggest differences may exist between men and women in terms of knee function before and after total knee replacement. This may be related to the efficacy of the procedure itself or to differences in the severity of disability of male and female patients at the time of surgery.


OBJECTIVE
We evaluated differences in the age, preoperative deformity, range-of-motion, and Knee Society scores of men and women who underwent TKA. All parameters were measured at the time of the initial preoperative evaluation and at postoperative followup.


METHODS
We studied 698 patients who underwent elective TKA between 1996 and 2007. This population consisted of 428 women (61%) and 270 men (39%), all of whom underwent rehabilitation utilizing a standardized hyperflexion protocol with immediate initiation of full weight-bearing postoperatively.


RESULTS
The men were on average three years younger than the women (mean 63.5 versus 66.6 years, respectively). Preoperative ROM, postoperative ROM, and changes in ROM and body mass index were similar between groups. Knee Society Knee scores were similar preoperatively (47.4 [men] versus 46.7 [women]), but four points higher in men at followup (89.2 versus 85.2). Women had lower Knee Function scores than men preoperatively (45.2 versus 57.1), and postoperatively (65.3 versus 73.9).


CONCLUSIONS
Women who undergo TKA seek treatment at a later stage than men and have greater functional disability at the time of surgery. Differences in functional scores persist after TKA. Earlier initiation of treatment may enhance postoperative outcome.


METHODS
Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Parsley
Brian S
BS
Baylor College of Medicine, 6620 Main, Suite 1325, Houston, TX, 77030, USA. bparsley@bcm.tmc.ed
Bertolusso
Roberto
R
Harrington
Melvyn
M
Brekke
Adam
A
Noble
Philip C
PC
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D004185:Disability Evaluation; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome