Total hip arthroplasty (THA) is a surgical procedure that replaces a diseased joint

with a synthetic joint using a synthetic acetabulum, femur, and polyethylene liner that are

fixed to bone by cement or bone ingrowths. Total knee arthroplasty (TKA) involves

replacing the femoral and tibia sides of the joint using a long or short stem fixated by

cement. The goal of joint arthroplasty is to improve function with an artificial joint that

improves range of motion and provides pain relief with few surgical complications

(Brander, Mullarkey, & Stulberg, 2001). The decision making process in considering a

candidate for total joint replacement is the degree of radiographic changes and the degree

of functional impairment.

Gender and Arthroplasty

 Although women have 1.5-2.0 higher incidence of osteoarthritis, men have more

total knee arthroplasty than women. Katz, et al. (1994) suggests that gender differences

in joint arthroplasty are difficult to evaluate because procedure rates are not reported by

severity of disease. The authors evaluated functional status using a daily living scale that

evaluates the ability to walk several blocks, climb stairs, or take part in vigorous activity.

Greater functional impairment and the use of walking support were reported for most of

the females. The authors suggest that males have earlier surgical intervention for

functional impairment and pain. Praemer, et al. (1999) do report that the number of total

knee replacements for men in 1996 was 1318/100,000 while for women in the same year

it was 928/ 100,000. There is some evidence that suggests women delay surgical

intervention out of fear of surgical failure, death or loss of function postoperatively.

Postponing surgical intervention can also be because of distrust of physicians and

hospitals, a reluctance to take risks and concern about caregiving responsibilities.