Sex of surgeon shows no significant impact on 90-day adverse events of primary THA
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Despite a slightly lower odds of 90-day adverse events for total hip arthroplasty procedures performed by female surgeons, published results found no significant association between surgeon sex and risk of these events following THA.
Per Jolbäck, RN, PhD, and colleagues at Skaraborg Hospital in Sweden performed a retrospective study that analyzed 11,993 primary THA procedures between 2008 and 2016 at 10 hospitals in western Sweden. Researchers noted surgeon-related information, such as sex, annual volume and level of training, as well as patient-related information, such as age, sex and Elixhauser comorbidity index. According to the study, the main outcome measure was 90-day adverse events, as defined by the Swedish Hip Arthroplasty Register.
Of the 200 surgeons included in the sample, 35 (17.5%) were women; of the 156 attending physicians, 22 (14.1%) were women; and of the 74 residents, 25 (33.8%) were women. Male surgeons had an average surgical case volume of 23 THAs in the last year of the study period, while female surgeons had an average surgical case volume of 19 THAs in the last year of the study period. Jolbäck and colleagues also noted female surgeons tended to operate on older patients (mean age of 72 years) and had a higher proportion of female patients (62%).
Overall, adverse event rates at 90 days after surgery were similar between female (6%) and male (7%) surgeons. After adjusting for patient- and surgeon-related information, researchers found slightly decreased odds of an adverse event (adjusted OR = 0.72) for THA procedures performed by female compared with male surgeons; however, this association was not deemed significant. Additionally, researchers found no association between surgeon sex and the rate of adverse events when including all surgeons, attendings and residents in the analysis.
“Stereotypes may prevail, but little is known about the influence that the sex of an orthopedic surgeon may have on outcomes,” the researchers wrote in the study. They added, “One practical implication of our findings is that they contribute to a growing body of literature that refutes the prejudice that women are less suitable than men as orthopedic surgeons. The presence of a sex bias has already been established in one aspect of the surgical field, with female medical students reporting a lack of fit between their perceptions of themselves and of what a surgeon must be, which suggests a lack of representation and visibility in surgery.”.
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