title: Women demonstrate more pain and worse function before THA but comparable results 12 months after surgery.
abstract: BACKGROUND
  Many studies report differences in patient-reported outcome measures (PROMs) for men and women undergoing total hip arthroplasty (THA). Few studies have evaluated whether these are explained by corresponding differences in important preoperative factors.
  
  
  OBJECTIVE
  (1) Are there differences between men and women in PROM scores preoperatively and 12 months after THA? (2) Do baseline differences in comorbidity, age, body mass index (BMI), and mental health status explain these differences in PROM scores?
  
  
  METHODS
  Preoperatively, 300 patients completed the Oxford Hip Score (OHS), WOMAC, and SF-12; 261 (86%) of them (129 women, 64 ± 11 years; 132 men, 66 ± 10 years) completed the same questionnaires 12 months postoperatively and also rated the acceptability of their current symptoms and change in general health.
  
  
  RESULTS
  Preoperatively, women showed worse scores than men in the OHS (-1.9; 95% confidence interval, -3.6 to -0.3) and WOMAC (-6.3; -10.9 to -1.7). At 12 months postoperatively, the absolute scores for all PROMs were not significantly different. After controlling for BMI, age, comorbidity, SF-12 mental health scores, and sociodemographic characteristics, the baseline differences remained.
  
  
  CONCLUSIONS
  Surgeons may be more reluctant to operate on women than men because they perceive that, because of their worse baseline status, women are likely to have worse outcomes; however, given that we found no evidence for differences in patient-reported outcomes at 12 months, these suspicions would appear to be unfounded. Women and men can be expected to benefit to a similar extent from THA.
  
  
  METHODS
  Level III, therapeutic study.
authors.affiliation: Department of Research and Development, Schulthess Clinic, Lengghalde 2, Zurich, 8008, Switzerland.
authors.forename: Anne F
authors.initials: AF
authors.lastname: Mannion
authors.affiliation: Department of Research and Development, Schulthess Clinic, Lengghalde 2, Zurich, 8008, Switzerland. franco.impellizzeri@gmail.com.
authors.forename: Franco M
authors.initials: FM
authors.lastname: Impellizzeri
authors.affiliation: Department of Orthopaedic Surgery, Schulthess Clinic, Zurich, Switzerland.
authors.forename: Florian D
authors.initials: FD
authors.lastname: Naal
authors.affiliation: Department of Orthopaedic Surgery, University of Berne, Berne, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Leunig
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000295:instrumentation; D001696:Biomechanical Phenomena; D005260:Female; D006304:Health Status; D054624:Health Status Disparities; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology*; D018579:Patient Selection; D011859:Radiography; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome