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Influence of Gender on Age of Treatment with TKA and Functional Outcome

  • Symposium: Gender-specific Issues in Orthopaedic Surgery
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

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.

Questions/purposes

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.

Level of Evidence

Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Drew Stal for his assistance in the preparation of our manuscript.

Author information

Authors and Affiliations

  1. Baylor College of Medicine, 6620 Main, Suite 1325, Houston, TX, 77030, USA

    Brian S. Parsley MD, Melvyn Harrington MD & Philip C. Noble PhD

  2. Rice University, Houston, TX, USA

    Roberto Bertolusso MA

  3. Institute of Orthopedic Research and Education, Houston, TX, USA

    Adam Brekke BA

Authors
  1. Brian S. Parsley MD
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  2. Roberto Bertolusso MA
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  3. Melvyn Harrington MD
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  4. Adam Brekke BA
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  5. Philip C. Noble PhD
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Corresponding author

Correspondence to Brian S. Parsley MD.

Additional information

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at Baylor College of Medicine, Houston, TX, USA.

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Parsley, B.S., Bertolusso, R., Harrington, M. et al. Influence of Gender on Age of Treatment with TKA and Functional Outcome. Clin Orthop Relat Res 468, 1759–1764 (2010). https://doi.org/10.1007/s11999-010-1348-y

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  • DOI: https://doi.org/10.1007/s11999-010-1348-y

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