Surgery is a daunting prospect for everyone. We worry about the pain, the lost time during recovery, and the outcome after a procedure.

See Total Hip Replacement Surgery Recovery

But when it comes to joint replacement, too many people are missing out on a good thing—especially women.

Women are much more likely to underutilize joint replacement as a treatment for their osteoarthritis. See Indications and Eligibility for Total Hip Replacement Surgery

Studies reveal that women have a much higher rate of waiting to have a joint replacement even after joint damage, symptoms, and disability are a real problem. Typically, their osteoarthritis is much more advanced by the time they have a joint replacement, compared with their male counterparts. In fact, one study estimates the rate of women underutilizing joint replacement is more than three times the rate for men.1

See Osteoarthritis Treatment

Why is this? After all, those same studies show that men and women have equal willingness to consider surgery as a treatment option. The reasons seem to be two-fold:

Reason 1: People fear postsurgical pain and recovery

Joint replacement is generally a successful procedure, with very high success and patient satisfaction rates.

But people don’t necessarily know that. They worry about postsurgical pain and disability. In one study, men and women alike had expectations about pain and physical outcomes that were much more pessimistic than actual outcomes.2

See Managing the Pain of Joint Replacement

Fears concerning joint replacement can be overcome fairly easily: by educating patients about joint replacement and its outcomes, so they can make an informed decision. But here’s where the gender difference come into play.

Reason 2: Physicians don’t do a good job informing female patients

Some studies have shown that physicians are less likely to discuss joint replacement when they’re treating women, compared with their male patients. In one study, doctors were less likely to share information about knee replacement and ask about treatment preferences with female subjects, compared with male subjects. They also had worse interpersonal skills with the female subjects.3

See Choosing a Surgeon for Total Knee Replacement

When women are given adequate information, they catch up quickly to their male counterparts. After subjects were given decision aids about joint replacement in one study, the female subjects had a better, more accurate understanding of the topic than the men.2

See The Pros and Cons of Minimally Invasive Knee Replacement Surgery

If you or someone you love is struggling with symptoms of an arthritic joint that’s not responding to nonsurgical treatments, don’t hesitate to ask your doctor about joint replacement—especially for women. Ask about your options, ask about outcomes, ask about consulting with an orthopedic surgeon…just ask!

Learn more:

Cemented vs. Cementless Alternatives in Joint Replacement

“When Can I…?” Answers for Knee Replacement Patients


  • 1.Hawker GA, Wright JG, Coyte PC, et al. Differences between men and women in the rate of use of hip and knee arthroplasty. N Engl J Med. 2000;342(14):1016-22.
  • 2.Volkmann ER, Fitzgerald JD. Reducing gender disparities in post-total knee arthroplasty expectations through a decision aid. BMC Musculoskelet Disord. 2015;16:16.
  • 3.Borkhoff CM, Hawker GA, Kreder HJ, Glazier RH, Mahomed NN, Wright JG. Influence of patients' gender on informed decision making regarding total knee arthroplasty. Arthritis Care Res (Hoboken). 2013;65(8):1281-90.