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Link Between Hormonal Factors and Total Knee Arthroplasty (TKA) in Women

Why is osteoarthritis-related disability greater among women than men?

Years of study have established that the age-adjusted rates of hip and knee arthroplasty are higher for women than for men in both the United States and Canada. Nonetheless, the reasons for this disparity have not been successfully explored until recently. It is well-known that women report worse pain and disability than men do at the time of surgery, suggesting that women receive treatment later in the course of their degenerative osteoarthritis (the most common reason for knee arthroplasty).

While the question of why women wait longer for surgery than their male counterparts has not been fully answered, strong clues relating to why arthritis is such a major health problem for women have been found in their hormonal makeup. If you are a woman suffering the disabling pain of osteoarthritis of the knee, don’t become a statistic — one of the women who waited too long for surgery. Instead, find out your treatment options now from a first-rate orthopedic surgeon who specializes in up-to-date procedures of the knee.

How Hormonal and Reproductive Factors Affect the Risk for TKA in Women

According to the results of recent studies published in Arthritis & Rheumatology have shown increased risk for TKA in women to include:

  • Prolonged years of menstruation
  • History of pregnancy
  • Increased number of pregnancies
  • Use of oral contraception
  • Current hormone replacement
  • Increased duration of hormone replacement therapy

Other questions asked of the participants in the recent study, which took place in Melbourne, Australia, included queries about age at menarche (first menstrual period) and menopausal status. The researchers linked records about this hormonal data with information from the National Joint Replacement Registry, adjusting all results for age, body mass index (BMI) at midlife, change in BMI from early reproductive age to midlife, country of birth, physical activity, smoking status, and education.

Overall, the study showed clearly that a history of pregnancy is associated with increased risk of TKA, as is lengthy use of oral contraceptives and current hormone replacement therapy. The latter, however, was only found to be significant only in women who were not obese at midlife.

The authors of the study suggest that the connection between pregnancy and increased risk for TKA  may be the result of weight gain and retention during pregnancy and before periods. Women may also gain some weight when they use oral contraception or take hormone supplements during or after menopause. Not only does carrying extra weight put more mechanical pressure on the knee joint, but extra weight can lead to inflammation and endothelial dysfunction (affecting the inner lining of the blood cells). While there is a clear correlation between female hormones and knee arthroplasty, the subject is a complex one, requiring further study.

Where to Look for Help

No matter what the cause, if you are a woman in need of knee arthroplasty, struggling with increasing pain and disability, you should contact an orthopedic surgeon who specializes in knee surgery and who uses the most innovative, effective treatments available.

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