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Women Recover Faster Than Men after Standard Knee Arthroplasty

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Specific anatomic differences are believed to account for gender-specific function and health-related quality of life after TKA. However, there are conflicting data in the literature regarding these gender-specific outcomes, especially as woman appear to have surgery later in the course of the disease compared with men.

Questions/purposes

We asked whether (1) women had worse knee function and health-related quality of life after TKA compared with men, (2) lower improvements in scores, and (3) slower recovery after surgery.

Methods

Using a cohort study design, we retrospectively analyzed prospectively collected data from three multicenter randomized controlled trials evaluating rehabilitation measures after standard unisex knee arthroplasty in 494 patients (141 men and 353 women). The primary outcome was self-reported physical function as measured by the WOMAC at 3, 6, 12, and 24 months after surgery. Secondary outcomes included the pain and stiffness scales of the WOMAC and the physical and mental component summaries of the SF-36. At the time of surgery, the women were on average older (70.8 versus 67.8 years), had lower mean physical function (55 versus 47), higher mean pain scores (54 versus 48), and greater stiffness (54 versus 46) as measured by the WOMAC.

Results

At the 3-, 6-, 12-, and 24-month followups, men and women had similar WOMAC scores. Improvements were greater for women compared with men for WOMAC function and pain subscale scores at the 3-month (function, 28 versus 23; pain, 32 versus 25) and 6-month followups (function, 32 versus 27; pain, 36 versus 31). At the 12- and 24-month followups we noted no differences in improvement between men and women.

Conclusion

Although women had greater functional limitations at the time of surgery than men, they recover faster early after standard TKA although function is similar at 12 and 24 months. Women also had greater improvement of WOMAC scores after standard TKA than men.

Level of Evidence

Level II, prognostic study. See the guidelines for authors for a complete description of levels of evidence.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Schleswig-Holstein Medical Center, Kiel Campus, Michaelisstr 1, 24105, Kiel, Germany

    Thoralf R. Liebs MD & Joachim Hassenpflug MD, PhD

  2. Department of Orthopaedics, Asklepios Westklinikum Hamburg, Hamburg, Germany

    Wolfgang Herzberg MD

  3. Department of Anaesthesiology, Asklepios Westklinikum Hamburg, Hamburg, Germany

    Annette Maria Roth-Kroeger MD

  4. Department of Orthopaedic Surgery, Rheumaklinik Bad Bramstedt, Bad Bramstedt, Germany

    Wolfgang Rüther MD, PhD

  5. University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Wolfgang Rüther MD, PhD

Authors
  1. Thoralf R. Liebs MD
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  2. Wolfgang Herzberg MD
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  3. Annette Maria Roth-Kroeger MD
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  4. Wolfgang Rüther MD, PhD
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  5. Joachim Hassenpflug MD, PhD
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Corresponding author

Correspondence to Thoralf R. Liebs MD.

Additional information

The institution of the authors (TRL, JH) has received funding from the Society for Support of Research in and Fighting of Rheumatic Diseases Bad Bramstedt, registered society (Verein zur Förderung der Erforschung und Bekämpfung rheumatischer Erkrankungen, Bad Bramstedt e. V.); the Society for Support of Rehabilitation Research in Schleswig-Holstein, registered society (vffr, Verein zur Förderung der Rehabilitationsforschung in Schleswig Holstein, e. V.); the State Insurance Agency of the Free and Hanseatic City of Hamburg (LVA Freie und Hansestadt Hamburg); and the German Arthrosis Society, registered society (Deutsche Arthrose-Hilfe e. V.).

Each author certifies that his or her institution 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 all academic affiliations mentioned plus the University of Schleswig-Holstein Medical Center, Lübeck Campus, Department of Orthopaedic Surgery, Lübeck, Germany; Ostseeklinik Damp, Department I of Orthopaedic Surgery, Damp, Germany; and Kliniken des Kreises Pinneberg, Krankenhaus Wedel, Wedel, Germany.

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Liebs, T.R., Herzberg, W., Roth-Kroeger, A.M. et al. Women Recover Faster Than Men after Standard Knee Arthroplasty. Clin Orthop Relat Res 469, 2855–2865 (2011). https://doi.org/10.1007/s11999-011-1921-z

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  • DOI: https://doi.org/10.1007/s11999-011-1921-z

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