Many
of us take our knees for granted without realizing how much strain
is placed on them from everyday activities. As we walk, run, bend,
twist and hustle, the knee—which is the largest
joint in the body—takes a regular beating. But for the more
than five million people who visit orthopedic surgeons each year
for knee problems, these intricate, hinge-like joints can become
more than a nuisance.
Knee problems can be debilitating and can result from a
variety of things ranging from injuries to degenerative conditions
to arthritis. According to the American Academy of Orthopedic Surgeons,
joint replacement surgery is more common in the knee joint than
any other joint in the body. Knee replacement surgery can alleviate
pain and help to restore function in a damaged or diseased joint.
Recently, knee implants designed specifically for women
have made their way into operating rooms around the country. The
implants of the past were designed based on men’s knees.
Often, smaller implants were used for women, but “a small
percentage of women complained of persistent pain around the kneecap
area,” according to Dr. Robert Bucholz, M.D., chairman of
orthopedic surgery at University of Texas Southwestern in Dallas.
Knee-related problems seem to affect women more often than
men. One study in Europe found that women had more knee-related
complaints than men at earlier ages. The same study revealed an
increase in complaints as women approached and reached menopause,
suggesting that hormonal fluctuations may play a role.
One of the most common reasons for knee replacement surgery is damage
to the joint from osteoarthritis, a degenerative condition caused by the breakdown
and loss of cartilage in one or more joints in the body. The result is often
pain, limited motion and partial loss of function. It is the most common type
of arthritis and affects women over the age of 45 more often than men in the
same age-range according to the National Institute of Arthritis and Musculoskeletal
and Skin Diseases.
Other studies have shown that female athletes are more likely
to experience an injury of the anterior cruciate ligament (ACL)
than male athletes who participate in the same sports. Researchers
theorize that biological sex differences, including hormones, neuromuscular
control and anatomical differences may explain the discrepancy.
“The distal femur of women’s knees is narrow and has less
bony thickness to its anterior trough,” Bucholz said, referring to the
bone that runs through the thigh. These anatomical gender differences mean
that a knee replacement for men may not be optimal for women. “The pull
of the quadriceps muscle is also different.”
Many in the field of orthopedics feel that these changes
addressing differences between woman and men are long overdue.
Because of the large number of people undergoing knee replacement
surgery each year, and because women represent the majority of
patients, sex-specific joint replacements may be the wave of the
future.
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