Epidemiological Situation of Hip Replacement Surgery: Gender Difference Responding

Life Sciences -Medical

Authors

  • Serdi Memini Orthopedic-Traumatologist at University Trauma Center, Tirana, Albania
  • Erjona Abazaj Institute of Public Health, Tirana, Albania https://orcid.org/0000-0003-2386-4605
  • Ela Ali Institute of Public Health, Tirana, Albania

DOI:

https://doi.org/10.22376/ijlpr.2023.13.4.L137-L145

Keywords:

total hip arthroplasty, gender difference, outcomes, trauma hospital, surgery, epidemiological data

Abstract

In some papers, differences in gender regarding the total hip arthroplasty (THA) replacement surgery response are reported. This study evaluated gender differences in response to patients undergoing total hip arthroplasty replacement surgery in our country. It is a cross-sectional and descriptive study that analyzed 401 patients admitted and undergoing THA at the University Trauma Center, Tirana, for five years. SPSS software 20.0 is used to analyze patient outcome measures. The logistic regression compared outcomes between genders. A p-value less than 0.05 was considered significant. The average age in this study was 67.1 +/- 5.4 years, with the range of min to max ranging from 22 to 89 years old.Women were the most predominant Gender, at 51.6% (207/401), compared to men, at 48.4% (194/401). The age group 60–70 years old had the most patients, accounting for 29.7% (119/401). In addition, women were more likely than men to be older, to have arthritis, and to have metabolic syndrome (P=0.001). The preoperative health of men was weaker despite being younger than women. Based on the logistic regression of the data, the length of hospital stay was significantly higher in women versus men. Still, on the other side, mobility after the replacement was much slower in men. Also, the men were less likely to return to their homes or mobilize independently during the 90-day follow-up. The findings of this study show a significant association between the gender effect and the outcomes of the replacement response. The total amount of arthroplasty used is more than four times as great in women as in men. We recommend future studies to clear up the underlying causes of gender differences in joint arthroplasty.

References

Quintana JM, Aróstegui I, Azkarate J, Goenaga JI, Elexpe X, Letona J et al. Evaluation of explicit criteria for total hip joint replacement. J Clin Epidemiol. 2000;53(12):1200-8. doi: 10.1016/s0895-4356(00)00244-4, PMID 11146265.

Röder C, Parvizi J, Eggli S, Berry DJ, Müller ME, Busato A. Demographic factors affecting the long-term outcome of total hip arthroplasty. Clin Orthop Relat Res. 2003 Dec;417(417):62-73. doi 10.1097/01.blo.0000096812.78689.f0, PMID 14646703.

Riddle DL, Perera RA, Jiranek WA, Dumenci L. Using surgical appropriateness criteria to examine outcomes of total knee arthroplasty in a United States sample. Arthritis Care Res, Hoboken. 2015 Mar;67(3):349-57. doi 10.1002/acr.22428, PMID 25132662.

Mannion AF, Impellizzeri FM, Naal FD, Leunig M. Women demonstrate more pain and worse function before THA but comparable results 12 months after surgery. Clin Orthop Relat Res. 2015 Dec;473(12):3849-57. doi: 10.1007/s11999-015-4479-3, PMID 26224293.

Novicoff WM, Saleh KJ. Examining sex and gender disparities in total joint arthroplasty. Clin Orthop Relat Res. 2011 Jul;469(7):1824-8. doi: 10.1007/s11999-010-1765-y, PMID 21213082.

Cheah C, Hussein IH, Sayeed Z, El-Othmani MM. We assess gender disparities in total joint arthroplasty from the national inpatient sample database. FASEB J. 2020;34(S1):1-. doi: 10.1096/fasebj.2020.34.s1.02904.

Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley JL. Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain. 2009;10(5):447-85. doi: 10.1016/j.jpain.2008.12.001, PMID 19411059.

Lund I, Lundeberg T. Is it all about sex? Acupuncture for the treatment of pain from a biological and gender perspective. Acupunct Med. 2008;26(1):33-45. doi: 10.1136/aim.26.1.33, PMID 18356797.

Holtzman J, Saleh K, Kane R. Gender differences in functional status and pain in a Medicare population undergoing elective total hip arthroplasty. Med Care. 2002 Jun;40(6):461-70. doi: 10.1097/00005650-200206000-00003, PMID 12021672.

Ethgen O, Bruyère O, Richy F, Dardennes C, Reginster JY. Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J Bone Joint Surg Am. 2004 May;86(5):963-74. doi: 10.2106/00004623-200405000-00012, PMID 15118039.

Peter WF, Dekker J, Tilbury C, Tordoir RL, Verdegaal SH, Onstenk R, et al. The association between comorbidities and pain, physical function, and quality of life following hip and knee arthroplasty. Rheumatol Int. 2015;35(7):1233-41. doi: 10.1007/s00296-015-3211-7, PMID 25586654.

ASA physical status classification system; Dec 13, 2020 (original approval: October 15, 2014). Last Amended. Available from: https://www.asahq.org/standards-and-guidelines/asa-physical-status-classification-system [cited 22/3/2023].

Hurwitz EE, Simon M, Vinta SR, Zehm CF, Shabot SM, Minhajuddin A et al. Adding examples to the ASA-physical status classification improves correct assignment to patients. Anesthesiology. 2017 Apr;126(4):614-22. doi 10.1097/ALN.0000000000001541, PMID 28212203.

Menendez ME, Neuhaus V, van Dijk CN, Ring D. The Elixhauser comorbidity method outperforms the Charlson index in predicting inpatient death after orthopedic surgery. Clin Orthop Relat Res. 2014 Sep;472(9):2878-86. doi: 10.1007/s11999-014-3686-7, PMID 24867450.

Nichols CI, Vose JG. Clinical outcomes and costs within 90 days of primary or revision total joint arthroplasty. J Arthroplasty. 2016 Jul;31(7):1400-1406.e3. doi 10.1016/j.arth.2016.01.022, PMID 26880328.

Pathak S, Ganduglia CM, Awad SS, Chan W, Swint JM, Morgan RO. Is post-discharge rehabilitation timing associated with 90-day readmission in primary total joint arthroplasty? HSS J. 2019 Oct;15(3):234-40. doi: 10.1007/s11420-019-09685-z, PMID 31624478.

Sibia US, Mandelblatt AE, Callanan MA, MacDonald JH, King PJ. Incidence, risk factors, and costs for hospital returns after total joint arthroplasties. J Arthroplasty. 2017 Feb;32(2):381-5. doi 10.1016/j.arth.2016.08.003, PMID 27597429.

Zmistowski B, Restrepo C, Hess J, Adibi D, Cangoz S, Parvizi J. Unplanned readmission after total joint arthroplasty: rates, reasons, and risk factors. J Bone Joint Surg Am. 2013 Oct 16;95(20):1869-76. doi: 10.2106/JBJS.L.00679, PMID 24132361.

Yoon PW, Lee YK, Ahn J, Jang EJ, Kim Y, Kwak HS, et al. Epidemiology of hip replacements in Korea from 2007 to 2011. J Korean Med Sci. 2014;29(6):852-8. doi: 10.3346/jkms.2014.29.6.852, PMID 24932089.

Araujo Wolfovitch L, Campos Falcao FR, Gomes Dias BA, Sadigursky D, Castro De Queiroz G, Leao Pinheiro M. Clinical and epidemiological profile of patients undergoing total hip arthroplasty. Rheumatol Orthop Med. 2017;2(3):1-5. doi: 10.15761/ROM.1000120.

Järvholm B, From C, Lewold S, Malchau H, Vingård E. Incidence of surgically treated osteoarthritis in the hip and knee in male construction workers. Occup Environ Med. 2008 Apr;65(4):275-8. doi 10.1136/oem.2007.033365, PMID 17928390.

Goveia VR, Mendoza IY, Couto BR, Ferreira JA, Paiva EB, Guimarães GL et al.. Profile of hip arthroplasty patients in a teaching hospital. Rev Col Bras Cir. 2015;42(2):106-10. doi: 10.1590/0100-69912015002007. PMID 26176676.

Hawker GA, Wright JG, Coyte PC, Williams JI, Harvey B, Glazier R et al. Differences between men and women in the rate of use of hip and knee arthroplasty. N Engl J Med. 2000 Apr 6;342(14):1016-22. doi: 10.1056/NEJM200004063421405, PMID 10749964.

Bryan AJ, Calkins TE, Karas V, Culvern C, Nam D, Della Valle CJ. Primary total hip arthroplasty in patients less than 50 years of age at a mean of 16 years: highly crosslinked polyethylene significantly reduces the risk of revision. J Arthroplasty. 2019 Jul;34(7S): S238-41. doi 10.1016/j.arth.2019.02.025, PMID 30935803.

Kostamo T, Bourne RB, Whittaker JP, McCalden RW, MacDonald SJ. No difference in gender-specific hip replacement outcomes. Clin Orthop Relat Res. 2009 Jan;467(1):135-40. doi 10.1007/s11999-008-0466-2. PMID 18780137, PMCID PMC2600988.

Hagen TP, Vaughan-Sarrazin MS, Cram P. Relation between hospital orthopedic specialization and outcomes in patients aged 65 and older: retrospective analysis of US Medicare data. BMJ. 2010 Feb 11;340:c165. doi 10.1136/bmj.c165, PMID 20150193.

Fang M, Noiseux N, Linson E, Cram P. The effect of advancing age on total joint replacement outcomes. Geriatr Orthop Surg Rehabil. 2015 Sep;6(3):173-9. doi: 10.1177/2151458515583515, PMID 26328232.

Lazzarini V, Mentz RJ, Fiuzat M, Metra M, O’Connor CM. Heart failure in elderly patients: distinctive features and unresolved issues. Eur J Heart Fail. 2013;15(7):717-23. doi: 10.1093/eurjhf/hft028, PMID 23429975.

Cho H, Klabunde CN, Yabroff KR, Wang Z, Meekins A, Lansdorp-Vogelaar I, et al. Comorbidity-adjusted life expectancy: a new tool to inform recommendations for optimal screening strategies. Ann Intern Med. 2013;159(10):667-76. doi: 10.7326/0003-4819-159-10-201311190-00005, PMID 24247672.

Gandhi R, Wasserstein D, Razak F, Davey JR, Mahomed NN. BMI independently predicts younger age at hip and knee replacement. Obesity (Silver Spring). 2010;18(12):2362-6. doi 10.1038/oby.2010.72, PMID 20379147.

Abdulla I, Mahdavi S, Khong H, Gill R, Powell J, Johnston KD, et al. Does body mass index affect the rate of adverse outcomes in total hip and knee arthroplasty? A retrospective review of a comprehensive joint replacement database. Can J Surg. 2020;63(2): E142-9. doi 10.1503/cjs.006719, PMID 32216250.

Rajgopal R, Martin R, Howard JL, Somerville L, MacDonald SJ, Bourne R. Outcomes and complications of total hip replacement in super-obese patients. Bone Joint J. 2013;95-B(6):758-63. doi: 10.1302/0301-620X.95B6.31438, PMID 23723268.

Alvi HM, Mednick RE, Krishnan V, Kwasny MJ, Beal MD, Manning DW. The Effect of BMI on 30-Day Outcomes Following Total Joint Arthroplasty. J Arthroplasty. 2015;30(7):1113-7. doi 10.1016/j.arth.2015.01.049, PMID 25683294.

Solarino G, Bizzoca D, Moretti AM, D’Apolito R, Moretti B, Zagra L. Sex and gender-related differences in the outcome of total hip arthroplasty: A current concepts review. Medicina (Kaunas). 2022;58(12):1702. doi: 10.3390/medicina58121702, PMID 36556904.

Wong SE, Pitcher AA, Ding DY, Cashman N, Zhang AL, Ma CB et al. The effect of patient gender on outcomes after reverse total shoulder arthroplasty. J Shoulder Elbow Surg. 2017;26(11):1889-96. doi: 10.1016/j.jse.2017.07.013, PMID 28911814.

Saltzman BM, Basques B, Leroux T, Frank RM, Nicholson GP, Verma NN, et al. The influence of gender on early adverse events, hospital charges, and length of stay after shoulder arthroplasty. Int Orthop. 2018;42(1):149-55. doi: 10.1007/s00264-017-3547-6, PMID 28689309.

Published

2023-07-01

How to Cite

Memini, S. ., Abazaj, E. ., & Ali, E. . (2023). Epidemiological Situation of Hip Replacement Surgery: Gender Difference Responding: Life Sciences -Medical. International Journal of Life Science and Pharma Research, 13(4), L137-L145. https://doi.org/10.22376/ijlpr.2023.13.4.L137-L145

Issue

Section

Research Articles