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Understanding the Observed Sex Discrepancy in the Prevalence of Osteoarthritis

Ferre, Isabella M. MPH1; Roof, Mackenzie A. BSc1; Anoushiravani, Afshin A. MD2; Wasterlain, Amy S. MD1; Lajam, Claudette M. MD1

doi: 10.2106/JBJS.RVW.18.00182
Review Articles

  • » When stratified by sex and age, there is a greater age-adjusted prevalence of osteoarthritis in women (23.5%) as compared with men (18.1%).
  • » The discrepancy between males and females in the prevalence of osteoarthritis is likely multifactorial, being related to hormonal, metabolic, structural, and nutritional differences.
  • » Cartilage is lost at a higher rate in women after accounting for confounding variables such as age, body mass index, and bone volume at baseline.
  • » Estrogen replacement therapy diminishes the expression of pro-inflammatory cytokines and reduces the prevalence of osteoarthritis in animal models and humans.
  • » Much work remains to understand the etiology of the sex gap seen in degenerative joint disease.

1Department of Orthopedic Surgery, NYU Langone Health, New York, NY

2Division of Orthopaedic Surgery, Albany Medical Center, Albany, New York

E-mail address for C.M. Lajam:

Investigation performed at NYU Langone Orthopedic Hospital, New York, NY

Disclosure: The authors indicated that no external funding was received for any aspect of this work. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (

Copyright © 2019 by The Journal of Bone and Joint Surgery, Incorporated
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