Sex-based Differences in Patient Perspectives and Experiences With Shoulder, Hip, and Knee Arthroplasty

J Am Acad Orthop Surg Glob Res Rev. 2024 Apr 19;8(4):e24.00083. doi: 10.5435/JAAOSGlobal-D-24-00083. eCollection 2024 Apr 1.

Abstract

Introduction: Sex disparities in presentation of osteoarthritis and utilization of joint replacement surgery (JRS) have been demonstrated. The role of patients' unique perspectives on JRS on their treatment decisions is poorly understood.

Methods: JRS candidates who were offered JRS but declined surgical treatment completed this survey. Survey questions included demographic information, patient experiences and current opinions around JRS, patient experiences with providers, goals and concerns, and barriers to JRS.

Results: More women experience barriers to undergoing JRS compared with men (53% versus 16%; P = 0.014). While both men and women indicated pain relief as their primary goal for treatment, women were significantly more likely to prioritize regaining the ability to complete daily tasks and responsibilities when compared with men (P = 0.007). Both men and women indicated that low symptom severity and nonsurgical treatment options were the reasons for not undergoing JRS (P = 0.455). Compared with men, women trended toward feeling that they were not sufficiently educated about JRS (P = 0.051).

Conclusion: Women have unique perspectives and goals for JRS that may pose sex-specific barriers to care. A better understanding of how patients' gendered experiences affect their decision making is necessary to improve treatment of osteoarthritis and decrease disparities in care.

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Hip*
  • Arthroplasty, Replacement, Knee*
  • Arthroplasty, Replacement, Shoulder
  • Female
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis / psychology
  • Osteoarthritis / surgery
  • Osteoarthritis, Hip / psychology
  • Osteoarthritis, Hip / surgery
  • Osteoarthritis, Knee / surgery
  • Sex Factors
  • Surveys and Questionnaires