Patient perceived outcomes after primary hip arthroplasty: does gender matter?

Background: Total hip arthroplasty (THA) provides high functional scores and long-term survivorship. However, differences in function and disability between men and women before and after arthroplasty are not well understood.

Questions/purposes: We determined if there was a gender difference in patient-perceived functional measures and range of motion in primary THA.

Methods: We retrospectively studied 532 patients (658 hips) undergoing primary THA. A total of 59% were women and 41% were men. Patients were assessed preoperatively and at minimum 2 years using Quality of Well-being, SF-36, WOMAC, and Harris hip score. We determined if differences existed between genders before and at followup for all dependent measures. Independent t-tests were also used to determine differences between genders concerning the change (Δ) scores and hip range of motion. The time course of perceived functional recovery was also documented.

Results: Males were on average 5 years (58) younger than females (63). Before surgery, females scored worse than males on the Harris hip score, WOMAC function, WOMAC pain, and WOMAC total scores. All scores improved at followup in both groups. Regardless of time, females had lower scores than males. However, females had greater improvement over males for WOMAC function (39 versus 35), WOMAC pain (11 versus 10), and WOMAC total (53 versus 48).

Conclusions: Substantial gender functional differences exist before treatment. However, women reported greater improvement as a result of the intervention when compared with men.

Level Of Evidence: Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.