Related Experiment Video
Updated: Jul 1, 2026

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
No difference in gender-specific hip replacement outcomes
Timothy Kostamo1, Robert B Bourne, John Paul Whittaker
1Division of Orthopaedic Surgery, London Health Sciences Centre, University of Western Ontario, London, ON, Canada.
Unlabelled:
Gender-specific total hip arthroplasty (THA) design has been recently debated with manufacturers launching gender-based designs. The purpose of this study was to investigate the survivorship and clinical outcomes of a large primary THA cohort specifically assessing differences between genders in clinical outcomes, implant survivorship, revisions as well as sizing and offset differences. We reviewed 3461 consecutive patients receiving 4114 primary THAs (1924 women, 1537 men) between 1980 and 2004 with a minimum of 2 years followup (mean, 11.33 +/- 6.5 years). A subset of patients with complete implant data was reviewed for sizing and offset differences. Preoperative, latest, and change in clinical outcome scores as well as Kaplan-Meier analysis were performed. Men had higher raw clinical outcome scores preoperatively and postoperatively. Differences in change of clinical outcome scores were found only in the WOMAC pain score in favor of the female cohort (39.4 versus 36.1). Survivorship and revision rate were not significantly different. Men used larger stems with greater stem lengths, neck offset, and neck lengths. Current implant systems were sufficiently versatile to address the different size and offset needs of male and female patients. These data suggest there is no apparent need for a gender-designed THA system.
Level Of Evidence:
Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
