Introduction: Prior studies reported higher prevalence of arthritis, greater disability, lower rate of utilization of total knee replacement (TKR) and total hip replacement (THR) in women as compared to men, as well as differences in outcomes after surgery. We examined sex differences in terms of demographic and clinical factors that influence surgical outcomes in a national sample of patients who underwent TKR or THR.

Methods: Patients undergoing primary THR and TKR from 7/1/11 through 12/03/12 were identified from a national research consortium that gathers demographic data, the Western Ontario and McMaster Universities Arthritis Index (WOMAC) estimated from the Knee injury and Osteoarthritis Outcome Score (KOOS) or the Hip injury and Osteoarthritis Outcome Score (HOOS), Short Form 36 Physical Component Score (PCS) and Mental Component Score (MCS) and musculoskeletal burden of illness. Descriptive statistics were performed.

Results: Primary TKR patients included 2042 women and 1276 men. Women were more likely nonwhite (11.2% vs. 7.5%), unmarried (40.3% vs. 17.8%), lower income (p

Conclusion: In this national sample, women undergoing primary THR and TKR have more severe arthritis, greater functional impairment and greater burden of musculoskeletal disease as compared to men. Understanding these differences will help tailor peri-operative care to the needs of the patients.