Introduction: Total hip arthroplasty (THA) is a commonly performed orthopaedic procedure, yet the correlation of patient sex with outcomes has been inadequately explored. Previous studies have been limited by population/database constraints. Thus, 90-day adverse event and 5-year outcome differences were assessed in a large national database. Methods: Patients undergoing THA from the 2010 to 2022 M165 Ortho PearlDiver Mariner Database were identified. Male and female patients were matched 1:1 based on age and Elixhauser Comorbidity Index. Ninety-day adverse events were assessed and compared with multivariable analysis adjusting for multiple comparisons. Five-year survival to revision, dislocation, and periprosthetic fracture was assessed by Kaplan-Meier analysis. Results: Of 780,745 THA patients, 333,974 (42.7%) were male and 446,771 (57.3%) were female. After matching, there were 327,978 male and 327,978 female patients. At 90 days, female patients had greater odds of any adverse events (odds ratio OR, 1.36), serious adverse events (OR, 1.76), minor adverse events (OR, 1.43), and readmissions (OR, 1.25; P < 0.001). Female patients had higher rates of surgical site infection, deep vein thrombosis, urinary tract infection, and wound dehiscence but lower rates of cardiac events, pneumonia, and acute kidney injury. At 5 years, female patients had higher rates of revision (1.8% vs. 1.4%, P < 0.001), fracture (1.2% vs. 0.7%, P < 0.001), and dislocation (1.8% vs. 1.2%, P < 0.001). Conclusion: This study identified notable sex-based differences in THA outcomes. Female patients had greater odds of perioperative complications and 5-year adverse events. These findings may inform patient counseling, surgical planning, and care pathways.
Ajjawi et al. (Mon,) studied this question.
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