When Evaluating Knee OA, Patient Gender Affects Whether a Physician Recommends Surgery
BY LAUREN UZDIENSKI, MARCH 20, 2008
According to a new study reported on by the New York Times, patient gender appears to influence whether physicians recommend they have a knee replaced. In a Canadian study, a male patient was told twice as often to have the surgery as a female patient with identical symptoms.
A male patient and a female patient, both 67, were confirmed to have identical levels of knee osteoarthritis by surgeons evaluating their x-rays. The patients gave identical descriptions of their condition to 29 orthopedic surgeons and 38 family physicians and asked, "Do you think I need a new knee?"
Two-thirds of the physicians told the male patient to have the joint replaced, but only a third made the same recommendation to the female patient. Researchers were not able to measure whether of the gender of the doctor affected the recommendation; only 12 of the doctors were women, and of them, five recommended surgery only to the man; two only to the woman; three to both; and two to neither.
The data appear to encourage women to be more proactive with their physicians in pursuing treatment for OA, and it adds an intriguing angle to the success of gender knees, which has been propelled by DTC advertising. A study released last month demonstrated that women tend to wait longer than men before having a knee replaced, and one of the reasons given was that they may be "following the doctor's orders" to put off the surgery as long as possible, reasoning that is also colored by this latest study's results. The physican as a barrier to knee replacement is of particular concern given the demongraphics of knee OA; the CDC reported that in older adults, men have a 45% lower "incident risk" than women for the condition.
