Reporting of Sex Specific Outcomes in High Impact Orthopedic Journals

Background: There are known biologic differences between men and women that affect all aspects of health and disease, including in orthopedics. Hormonal regulation influences bone density, tissue structure, joint laxity, and muscle mass. Differences in anatomy and neuromuscular control have also been identified. While previous studies on disease incidences have shown certain conditions are more common in one sex (e.g., osteoarthritis in women), it is not routine practice to evaluate or publish outcomes based on sex. Objectives: To evaluate the frequency with which papers in orthopedic journals published sex-specific outcomes with regard to knee osteoarthritis and rotator cuff pathology. Methods: Four high-impact orthopedic journals were reviewed: Journal of Bone and Joint Surgery (JBJS), Clinical Orthopedics and Related Research (CORR), American Journal of Sports Medicine (AJSM), and Journal of Arthroplasty (JOA). JBJS and CORR were reviewed for rotator cuff and knee osteoarthritis. AJSM was reviewed for rotator cuff, while JOA was reviewed for knee osteoarthritis. 100 articles from each journal were reviewed. If there was any further analysis of sex beyond the statement of how many men and women were included in each group, a study was designated as successfully reporting sexspecific outcomes. Results: 24-29% of rotator cuff articles reported on sex-specific outcomes. Sex specific outcomes were reported in 32-40% of knee osteoarthritis publications. Comparing rotator cuff to knee osteoarthritis articles, there was a trend toward more publications with sex-specific outcomes in knee osteoarthritis, however, this was not statistically significant (p = 0.0562). JBJS publishes significantly more articles reporting sex specific outcomes regarding knee osteoarthritis than rotator cuff (p= 0.0156). Conclusions: Sex-specific outcomes are not widely reported in high-impact orthopedic journals. Sexspecific outcomes are reported more often in knee osteoarthritis where there are already well-known sexbased differences. To improve care, sex-specific outcomes should be reported across all orthopedic conditions.https://jdc.jefferson.edu/sexandgenderhealth/1028/thumbnail.jp