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Gender-Specific Designs Not Required for
Hip Replacement: Presented at AAOS
SAN FRANCISCO March 7, 2008 - According to prospective
data analysed in a poster presentation here at the
American Academy of Orthopaedic Surgeons (AAOS) 75th
Annual Meeting, there is no support for the notion that
women need gender-specific designs for the total hip
replacements (THRs) now on the market, which are
tailored to their smaller stature and different anatomy.
Investigator Robert Barry Bourne, MD, Professor,
Division of Orthopaedic Surgery, University of Western
Ontario, London, Ontario, Canada, reported that implant
survival and function ratings actually favour women
undergoing hip replacement.
Dr. Bourne reached this conclusion after considering
findings from 1,924 women and 1,537 men who underwent a
total of 4,114 consecutive THRs after at least 2 years
following the surgery.
Pain scores on the Western Ontario and McMaster
Universities (WOMAC) Osteoarthritis Index favoured women
(39.42 vs 36.13; P = .011). Women had better improvement
in other scores, including the Hospital for Special
Surgery pain, Health Survey Short Form Mental Scale, and
WOMAC function scores, although the differences were not
statistically significant.
Cumulative survivorship at 10 years and 15 years (Kaplan
Meier analysis) was 0.903 and 0.785, respectively, for
women and 0.893 and 0.734 for men. These differences
were not statistically significant, Dr. Bourne said.
Revision rates did not differ significantly between
women and men (8.3% vs 9.3%).
Dr. Bourne called gender-specific joint replacement "a
hotly debated topic with a lack of evidence" to guide
surgeons in choosing either standard or gender-specific
devices. He claimed that the known anatomic differences
between male and female hip joints can be accommodated
"within the versatility of the system we have" using
standard design devices.
"There seems to be little need for gender-specific
implants," he concluded.
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