Patient perceived outcomes after primary hip arthroplasty: does gender matter?
BACKGROUND
Total hip arthroplasty (THA) provides high functional scores and long-term survivorship. However, differences in function and disability between men and women before and after arthroplasty are not well understood.


OBJECTIVE
We determined if there was a gender difference in patient-perceived functional measures and range of motion in primary THA.


METHODS
We retrospectively studied 532 patients (658 hips) undergoing primary THA. A total of 59% were women and 41% were men. Patients were assessed preoperatively and at minimum 2 years using Quality of Well-being, SF-36, WOMAC, and Harris hip score. We determined if differences existed between genders before and at followup for all dependent measures. Independent t-tests were also used to determine differences between genders concerning the change (Δ) scores and hip range of motion. The time course of perceived functional recovery was also documented.


RESULTS
Males were on average 5 years (58) younger than females (63). Before surgery, females scored worse than males on the Harris hip score, WOMAC function, WOMAC pain, and WOMAC total scores. All scores improved at followup in both groups. Regardless of time, females had lower scores than males. However, females had greater improvement over males for WOMAC function (39 versus 35), WOMAC pain (11 versus 10), and WOMAC total (53 versus 48).


CONCLUSIONS
Substantial gender functional differences exist before treatment. However, women reported greater improvement as a result of the intervention when compared with men.


METHODS
Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Lavernia
Carlos J
CJ
Orthopaedic Institute at Mercy Hospital, 3659 South Miami Avenue, Suite 4008, Miami, FL 33133, USA. CLavernia@mercymiami.org
Alcerro
Jose C
JC
Contreras
Juan S
JS
Rossi
Mark D
MD
D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000534:rehabilitation*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000503:physiopathology / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D012647:Self-Assessment; D012737:Sex Factors