Biological Sex Is Under-Reported in Cartilage-Related Preclinical Research: A Cross-Sectional Analysis

Area of Science:

• Orthopedics
• Musculoskeletal Research
• Preclinical Research

Background:

• Intervertebral disc degeneration (IDD) and osteoarthritis (OA) share molecular pathways and biological sex is a known risk factor.
• Sex bias in orthopedic preclinical research impacts knowledge, reproducibility, and translational research.
• Understanding donor sex reporting is crucial for addressing sex bias in musculoskeletal research.

Purpose of the Study:

• To comprehensively review donor sex reporting in intervertebral disc degeneration (IDD) and osteoarthritis (OA) preclinical research.
• To assess the inclusion of donor sex data in analyses and journal reporting requirements.
• To identify gaps in sex reporting in musculoskeletal research.

Main Methods:

• Cross-sectional study of original articles from high-impact journals.
• Analysis of donor sex reporting in human and animal samples and in vivo models.
• Evaluation of journal policies on sex reporting requirements.

Main Results:

• Donor sex was reported in only 61.9% of 284 cases.
• When reported, studies predominantly used male donors (56%) and rarely analyzed sex as a variable (3.4%).
• Despite journal requirements, 37.7% of papers failed to report donor sex.

Conclusions:

• Under-reporting of donor sex in OA and IDD research contributes to poor clinical translation and the replication crisis.
• Findings highlight the need for improved sex reporting standards in preclinical musculoskeletal research.
• Recommendations provided for journal policies, institutional guidelines, and funding requirements.