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Gender should be considered in diagnosis and treatment of musculoskeletal diseases
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When caring for orthopedic patients, physicians must consider the role of hormones, differential anatomy, joint stability and bone quality, as well as differences in recovery after injury and surgery among men and women, according to researchers.
In a recently published literature review, the researchers found women had a significantly higher incidence of ACL injuries compared with age- and sport-matched men, which was believed to be due to neuromuscular differences and significantly greater activation of knee joint-stabilizing muscles in women, as well as sex differences in knee abduction angle and flexion velocity in jump landing. Other findings were suggestive that a shift in estrogen and progesterone levels may have an impact on the ACL, according to the researchers.
Looking at hip and knee fractures, the researchers found the risk of hip fractures was three-times lower in men vs. women, and women also had a higher risk of developing osteoarthritis of the knee, with a higher burden of disease, greater pain and functional impairment at the time of total knee arthroplasty. Results of several studies also showed men who experienced hip fractures went untreated for osteoporosis. The researchers concluded it is important to make the connection of possible osteoporosis in men who sustained a hip fracture so they can take necessary steps in preventing further fractures.
The researchers also noted higher rates of ankle sprains, shoulder instability, de Quervain tenosynovitis and thumb carpometacarpal arthritis in women vs. men.
“Knowing that there are differences in incidences in presentation between males and females is an important part of diagnosing and treating patients,” Jennifer Moriatis Wolf, MD, an orthopedic surgeon at the University of Connecticut Health Center and lead author of the literature review, said in a press release. “Identifying both similarities and differences will allow health care providers to deliver better care to every orthopedic patient.”
Disclosures: Wolf reports that she or an immediate family member serves as a board member, owner, officer or committee member of the American Society for Surgery of the Hand, the American Foundation for Surgery of the Hand and the Ruth Jackson Orthopaedic Society. Please see the full study for a list of all other authors’ relevant financial disclosures.
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