Men undergoing relatively low-risk surgery to have their knee replaced face a higher risk of certain complications than women, new research suggests.
Men who had total knee replacement (TKR) were found to be more likely to develop wound infection and to have higher revision rates at five years when compared to women, the researchers said, but stressed the fact that TKR is a safe and effective procedure overall with the rate of serious complications for both men and women being low at less than 2%.
In a risk-adjusted analysis, TKR was found to be slightly riskier in men than in women, which in practice means that men need closer monitoring in the follow-up period, said the study co-author Dr Jasvinder Singh from the University of Alabama at Birmingham School of Medicine.
The study, published in Arthritis Care & Research online, looked at data from some 18,000 knee replacement surgeries conducted in Pennsylvania over the course of 12 months. The average age for both the male and female TKR patients was 69.
The research found that men had a 48% higher mortality risk from any cause after one year and a 31% higher risk of wound infection. The higher mortality risk could be explained with the gender-specific cardiovascular disease mortality disadvantage for men, the researchers said.
The study also revealed that the risk of hospital readmission within 30 days was 25% higher in men than in women and the five-year revision rate was 20% higher in male than in female patients. The higher revision rate in men could be put down to the higher physical activity of men and the differences in knee biomechanics.
When it comes to specific complications appearing within a month of surgery, such as blood clots, heart attack or prosthetic failure, the rate was similar in men and women.
The study has limitations, for example the lack of information about BMI, pre-operative pain and the severity of the arthritis, and further research is needed on the underlying causes to develop strategies to improve outcomes.