Gender Issues in Total Hip Arthroplasty: Length, Offset, and Osteoporosis

Total hip arthroplasty is a highly successful operation, yet outcomes in women tend to be inferior to those in men. Many differences have been hypothesized to account for these outcomes. Anatomic differences between the male and female hip are important variables with significant impacts on appropriate reconstruction of leg length and offset. In addition, osteoporosis is significantly more prevalent in the female population, further impacting the anatomic differences. We present a classification system describing six female femoral subtypes and discuss the importance of recognizing gender differences in reconstructive hip surgery.