Knee Replacement in Women — What You ‘Kneed’ to Know

Being a woman can be rough on the knees. So said Eric Gordon, MD, who explained that physical and systemic differences between the sexes increase a woman’s risk of knee deterioration and, ultimately, may necessitate knee replacement. 

Statistics from the American Joint Replacement Registry underscore the vulnerability of the female knee: Nearly 60% of knee replacements performed in the United States in 2022 were in women. 

“When you consider numerous factors, women are considerably more likely than men to have knee replacement,” said Dr. Gordon, an orthopedic surgeon with Hunterdon Health. He said these factors include:

Anatomy. Male and female musculoskeletal systems begin to differ in the teenage years. While there are exceptions, girls generally have looser joints, slightly less muscle mass, and more narrow spaces inside and around parts of the knees, compared with boys. Also, girls tend to be “knock-kneed” (knees tilting inward), while most boys are bow-legged (knees pointing outward). 

Athleticism. Girls and women who run or play team sports are more susceptible than male athletes to certain knee injuries, such as meniscus tears and injuries to ligaments (fibrous tissue that connects bones, joints and organs) or cartilage (flexible connective tissue that protects joints and bones). Though these injuries heal in the short term, they can cause cumulative damage to the knee over a lifetime.

Age-related conditions. Most women maintain a healthy bone density until menopause, at which point density loss accelerates. As the bones weaken, the risk of fractures and cartilage breakdown is heightened, posing more danger to the knee. Women also are more susceptible than men to autoimmune diseases that can affect the bones and joints, such as rheumatoid arthritis and multiple sclerosis. 

Weight. Nearly 3 in 4 American adults aged 20 and older are overweight or obese, the U.S. Centers for Disease Control and Prevention report. With increased weight comes decreased muscle mass, increased pressure on joints and weakened feet and legs — all of which can induce injury and hasten knee breakdown. 

When to consider knee replacement 

People with chronic knee pain typically consider knee replacement as they approach retirement age, with the goal of eliminating persistent pain and enriching their golden years, Dr. Gordon noted. Women tend to be healthier than men at retirement, and healthier and health-conscious individuals are more likely than chronically ill persons to opt for knee replacement, he added. 

Compared with men, women also have more favorable outcomes, heal more quickly and are stronger overall after knee replacement surgery, Dr. Gordon said, although the reasons for this are unclear. 

Regardless of the patient’s sex, the goal of any knee replacement procedure is to restore function as quickly and painlessly as possible, Dr. Gordon said. To achieve that goal, he noted, the orthopedic surgery team at The Center for Bone and Joint Health at Hunterdon Medical Center employs the latest surgical techniques and multimodal pain management to minimize pain, shorten recovery time and optimize outcomes.

“We’re staying current,” Dr. Gordon said, “and our specialized teams provide patient care throughout the process.” He added that the center offers a dedicated and specialty-trained team of nurses, physical therapists and occupational therapists. Patients receive comprehensive education on their knee replacement before and after surgery, as well as access to a dedicated Orthopedic Nurse Navigator at every step of the treatment journey. 

Finally, the orthopedic surgeon notes, that when it comes to knee replacement, one size definitely does not fit all — or even one sex. While women generally have taller and narrower knees than men, knee size and shape varies widely within each sex, Dr. Gordon said, adding that knee implants now come in a range of widths and heights, so the perfect match can be found for each patient. 

To learn more about Dr. Gordon and the knee replacement services he provides, call MidJersey Orthopaedics at 908-782-0600 or visit www.midjerseyortho.com/.  For information about the comprehensive services provided by Hunterdon Health’s Center for Bone and Joint Health, visit www.hunterdonhealth.org/services/orthopedics.