The Clinical Effect of Gender on Outcome of Total Knee Arthroplasty

Abstract The purpose of this study was to quantify the effect of sex on the clinical outcome and survivorship of a total knee arthroplasty (TKA) with clinical and radiographic follow-up. Seven thousand three hundred twenty-six primary AGC (Biomet, Warsaw, Ind) cruciate-retaining TKAs were performed from 1987 to 2004. Of these, 59.5% were performed on women. We examined preoperative and postoperative Knee Society knee score, function scores, pain scores, walking ability, stair-climbing ability, flexion, and implant survivorship based on sex. Female sex was associated with lower overall preoperative clinical scores for all parameters ( P < .01). Improvement in Knee Society knee score and flexion was greater for women ( P = .006), and there were equal pain relief and walking improvements for both sexes ( P < .32). Stair and function score improvements were greater for men ( P = .002). Implant survival was 98% for women and men at 15 years ( P = .4684). We conclude that improvement after TKA is similar for men and women, with few clinically significant differences. Sex-specific implants would appear to offer no clinical advantage.