Women have less complications than men after knee and hip replacement ops – new research from Canada
Complications and the need for revision surgery after major joint operations are rare, but men face slightly higher odds, according to research presented at the 2015 Annual Meeting of the American Academy of Orthopaedic Surgeons.
A team looked at data on total hip and knee replacements in a Canadian hospital over a seven year period. There were 37,881 total hip replacements (53.8% female) and 59,564 total knee replacements (60.5% female).
Women who had total hip replacements were significantly older than men (70 years vs 65 years) but men and women who had knee replacements were an average of 68 years. More women who had total joint replacement were defined as frail.
Results
After surgery men were:
• 15% more likely to return to the emergency department within 30 days of hospital discharge following either hip or knee replacements;
• 60% and 70% more likely to have a heart attack within three months following total hip replacement and total knee replacement, respectively;
• 50% more likely to require a revision arthroplasty within two years of total knee replacement;
• 25% more likely to be readmitted to hospital and 70% more likely to experience an infection or revision surgery within two years of total knee replacement, compared to women.
So although women usually have their first total joint replacement at an older age and are more likely to be frail, they are still less likely to have complications related to their surgery or need revision surgery. The findings contradict the theory that total joint replacement is underutilised in women because they have worse outcomes then men.
“Despite the fact that women have a higher prevalence of advanced hip and knee arthritis, prior research indicates that North American women with arthritis are less likely to receive joint replacement than men,” explains lead study author Dr Bheeshma Ravi. “One possible explanation is that women are less often offered or accept surgery because their risk of serious complications following surgery is greater than that of men.
“In this study, we found that while overall rates of serious complications were low for both groups, they were lower for women than for men for both hip and knee replacement, particularly the latter. Thus, the previously documented sex difference utilization of total joint replacement cannot be explained by differential risks of complications following surgery.”
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