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I saw a report on TV that women are much less likely to get a knee replacement compared with men. Is this because women aren't offered the option? Or do they just refuse?

There is much debate around this question. It is clear that women are more likely to have knee osteoarthritis (OA) compared to men. And their symptoms are usually worse. They are also more likely to be disabled from this condition compared to men.

Researchers are trying to account for the differences. They have looked at male versus female anatomy as one possible cause. Even though there are differences in the knee joint between men and women, no one has been able to show that it's these anatomical variations that make a difference.

Studies also show that women are much less likely to have a knee or hip replacement compared with men. In fact, it's estimated that women are four times more likely to need a joint replacement but don't have one.

It does not appear to be because women are unwilling to have surgery. It may be more likely that the option is not offered to women as often as it is to men. This may be a gender bias on the part of physicians. It could be the way men communicate with their doctors compared with women.

The pattern of gender differences extends beyond joint replacement. Studies also show that women who need coronary artery bypass surgery or kidney transplant are also less likely to have these operations compared with men.

Some experts think these differences can be changed with patient education. Teaching women what to say to their doctors or what questions to ask may help. Better understanding of their own health and treatment options available for any condition may also help.

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