Gendermedizin in der Knorpelchirurgie

Chondrocytes, similar to bone tissue, are sensitive to sex hormones, but there are also gender-specific differences in estrogen-binding capacity. Gender-specific differences in cartilage tissue can already be observed in children. However, this fact is considered in less than 1/3 of the studies in the existing literature. Female patients often exhibit poorer functional outcomes after cartilage regenerative procedures. However, clinical improvement, starting from lower baseline values, is often comparable to male patients. Since gender is always associated with different confounders in the context of retrospective evaluations and registry studies, making a definitive statement regarding gender-specific differences in patient-reported outcome measures (PROM) is challenging. The generally poorer PROM in women must also be considered in the context of their generally poorer subjective assessment of their health, as women worldwide rate their health lower than men. Therefore, a factor for adjusting this difference should be discussed in the PROM used. Whether this is a factor for worse outcomes or shorter survival of cartilage therapy is still unclear. Despite better improvement in PROM in several studies, women were more dissatisfied postoperatively, and an increased reoperation rate in females after cartilage regenerative procedures has been described by several authors. However, the exact reasons remain unclear. This should be the focus of orthopedic gender research in the coming years.