Related Experiment Video
Updated: Aug 5, 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
Gender-Based Differences in Arthroplasty Utilization Across Two Tertiary Academic Centers
Mikayla R Mefford1, Charlotte F Wahle, Emma D Grellinger
1From the David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA (Ms. Mefford and Ms. Wahle); the School of Medicine, University of California San Francisco, San Francisco, CA (Ms. Grellinger and Ms. Chi); the Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA (Dr. Newman-Hung, Dr. Stavrakis, and Dr. Wessel); the Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA (Dr. Woolley, Dr. Dlott, and Dr. Wong); and the Division of General Internal Medicine and Health Services Research, University of California Los Angeles, Los Angeles, CA (Dr. Jackson).
Gender influences joint replacement surgery decisions. Men felt encouraged to have surgery, while women perceived bias and tried conservative treatments first, highlighting disparities in care.
Area of Science:
- Orthopedics
- Gender Studies
- Health Disparities
Background:
- Women experience higher osteoarthritis prevalence and symptom severity but undergo joint replacement surgery (JRS) less frequently than men.
- Potential disparities in JRS utilization may stem from cultural norms, healthcare access, physician bias, and patient preferences, though specific gender-related barriers remain unclear.
Purpose of the Study:
- To investigate gender-specific barriers and influences on joint replacement surgery (JRS) decision-making among patients offered but declining surgery.
- To explore patient experiences and perceptions related to JRS to identify potential gender-based disparities.
Main Methods:
- Focus groups (FGs) were conducted with patients who declined JRS, recruited from two academic centers.
- Data included demographics, clinical severity (Kellgren-Lawrence grade, pain scores), comorbidities, and prior treatments.
- Qualitative analysis of FG discussions explored patient treatment experiences and decision-making factors.
Main Results:
- The study included 976 JRS candidates (60% female); no significant sex differences in JRS utilization were observed in the database.
- Focus group participants (24 total, 12 men, 12 women) reported negative physician interactions and prioritized return to lifestyle.
- Men focused on hobbies and recovery support, feeling encouraged towards surgery. Women prioritized household duties, cosmetic outcomes, and were more likely to trial conservative treatments, reporting age- and gender-based biases.
Conclusions:
- Gender significantly impacts patient experiences and decision-making processes for joint replacement surgery (JRS).
- Men reported feeling supported for surgery, whereas women perceived bias and exhausted conservative options first.
- Shared decision-making frameworks are crucial to address and mitigate gender-based disparities in surgical care access and outcomes.
