Rhon DI, Greenlee TA, Dickens JF, Wright AA. Are We Able to Determine Differences in Outcomes Between Male and Female Servicemembers Undergoing Hip Arthroscopy? A Systematic Review.
Orthop J Sports Med 2021;
9:23259671211053034. [PMID:
34805422 PMCID:
PMC8600561 DOI:
10.1177/23259671211053034]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 08/04/2021] [Indexed: 11/16/2022] Open
Abstract
Background:
Female servicemembers sustain higher rates of lower extremity injuries as
compared with their male counterparts. This can include intra-articular
pathology in the hip. Female patients are considered to have worse outcomes
after hip arthroscopy for femoroacetabular impingement and for hip labral
repair.
Purpose:
To (1) compare published rates of hip arthroscopy between male and female
military servicemembers and (2) determine if there are any sex-based
differences in outcomes after hip arthroscopy in the military.
Study Design:
Systematic review; Level of evidence, 3.
Methods:
We reviewed the literature published from January 1, 2000, through December
31, 2020, to identify studies in which hip arthroscopy was performed in
military personnel. Clinical trials and cohort studies were included. The
proportion of women within each cohort was identified, and results of any
between-sex analyses were reported.
Results:
Identified were 11 studies that met established criteria. Studies included
2481 patients, 970 (39.1%) of whom were women. Surgery occurred between
January 1998 and March 2018. Despite women accounting for approximately 15%
of the active-duty military force, they represented 39.1% (range,
25.7%-57.6%) of patients undergoing hip arthroscopy. In most cases, there
were no differences in self-reported outcomes (pain, disability, and
physical function), return to duty, or medical disability status based on
sex.
Conclusion:
Women account for approximately 15% of the military, but they made up 40% of
patients undergoing hip arthroscopy. Outcomes were not different between the
sexes; however, definitive conclusions were limited by the heterogeneity of
outcomes, missing data, lack of sex-specific subgroup analyses, and zero
studies with sex differences as the primary outcome. A proper understanding
of sex-specific outcomes after hip arthroscopy will require a paradigm shift
in the design and reporting of trials in the military health system.
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