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Comment & Response
September 9, 2013

A Different Point of View on Sex and Risk of Hip Implant Failure and Failure Rate in Women—Reply

Author Affiliations
  • 1Department of Surgical Outcomes & Analysis, Southern California Permanente Medical Group, San Diego, California
  • 2Patient-Centered Comparative Effectiveness Program and Medical Device Epidemiology Science and Infrastructure Center, Weill Medical College of Cornell University, New York, New York
JAMA Intern Med. 2013;173(16):1558-1559. doi:10.1001/jamainternmed.2013.8129

In Reply Although our study was not designed to evaluate the suggestion by Glaser and Glaser that a higher incidence of falls in women may explain the sex differences in risk of total hip arthroplasty revision, we reviewed the current literature on falls after total joint arthroplasty and found 3 relevant articles with large cohorts. In one study, with a 0.85% fall rate, men were at higher risk of falls1; another study reported a 1% fall occurrence, with women at higher risk2; finally, the third study reported a 0.9% fall occurrence and no difference between men and women.3 Only limited inference can be made from these studies’ inconsistent findings because they do not have long-term fall surveillance and include other arthroplasty or orthopedic procedures in their study samples. However, these studies highlight that the proposed higher risk of fall in women after arthroplasty is not yet documented in the literature. At this time we have no reason to believe that the incidence of these events would be differential in men and women. Nonetheless, this is an interesting suggestion and hope that future research will address this question.

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