Gender Disparities in Shoulder Pain and Shoulder Surgery: A Current Concepts Review

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Science

Background:

• Shoulder pain and surgery are common, affecting rotator cuff disease, osteoarthritis, and instability.
• Gender significantly impacts disease presentation, outcomes, and recovery, but findings are inconsistent.

Purpose of the Study:

• To review current evidence on gender's influence on shoulder pathologies and surgical outcomes.
• To synthesize data on pre-operative characteristics, non-operative management, and post-operative results.

Main Methods:

• Comprehensive literature search (PubMed, Cochrane Library, Google Scholar) up to October 2025.
• Analysis of studies on rotator cuff repair, shoulder arthroplasty, and instability surgery.
• Outcome assessment using validated instruments (e.g., ASES, Constant-Murley, SPADI).

Main Results:

• Females show worse pre-operative scores and higher pain, irrespective of structural severity.
• Both genders improve post-surgery, but females report higher early pain and lower absolute outcomes after arthroplasty and instability surgery.
• Outcomes for rotator cuff repair and anterior instability are similar between genders.

Conclusions:

• Gender-specific differences in shoulder conditions and surgical outcomes exist.
• Awareness is crucial for patient counseling, expectation management, and tailored treatment strategies.
• Future research needs gender-disaggregated data for robust analysis.