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. 2023 Sep;47(9):2143-2171.
doi: 10.1007/s00264-023-05876-w. Epub 2023 Jul 12.

Gender equality challenges in orthopaedic surgery: a systematic review

Evmorfia Pechlivanidou  1   2 , Ioannis Antonopoulos  3 , Rodanthi E Margariti  4
Affiliations

Gender equality challenges in orthopaedic surgery: a systematic review

Evmorfia Pechlivanidou et al. Int Orthop. 2023 Sep.

Abstract

Purpose: Several studies have examined gender-equality challenges and ways to improve women's representation and management. Orthopaedic surgeons and patients are less gender equitable than them of other surgical disciplines. This systematic review summarizes these findings and highlights orthopaedic surgery gender inequality.

Methods: Search of the PubMed, Embase, and Cochrane databases was carried out to extract human studies investigating the gender gap in orthopaedics, trying to highlight the equality challenges orthopaedic surgery faces. Studies incorporating patients with comorbidities in which gender is a proven risk factor, and pregnant women were excluded.

Results: This systematic review included 59 studies involving 692,435 people (mean females/males ratio: 4.44), spanning the years 1987-2023. Regarding the targeted population, 35 (59.32%) studies focused on patients, while 24 (40.68%) on physicians. Orthopaedic surgery is described as an unfriendly career field for women as surgeons or sports leading physicians while women are generally under represented in the academic field of orthopaedics. Regarding patients, female gender consists both a risk and prognostic factor influencing the prevalence of degenerative disease and the outcome of the operative treatment in reconstructive orthopaedics. Female gender is a risk factor for multiple sports injuries and influences the pathogenetic mechanisms resulting in ACL reconstruction. Regarding spine surgery, women are less likely to have surgery suggested, and such suggestion underlines severe disease's progression.

Conclusions: Gender differences affect orthopaedic patient-physician-healthcare system interactions. Recognizing biases and their patterns is useful to improve the actual situation. By preventing those an unbiased, tolerant, and egalitarian workplace for physicians and a healthcare system that provides the best treatment to patients could be created.

Keywords: Equality challenges; Female patients; Female physicians; Gender discrimination; Orthopaedic surgery.

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References

    1. de Borja C, Chang CJ, Watkins R, Senter C (2022) Optimizing health and athletic performance for women. Curr Rev Musculoskelet Med 15(1):10–20. https://doi.org/10.1007/s12178-021-09735-2 - DOI - PubMed - PMC
    1. Harbold D, Dearolf L, Buckley J, Lattanza L (2021) The Perry initiative’s impact on gender diversity within orthopedic education. Curr Rev Musculoskelet Med 14(6):429–433. https://doi.org/10.1007/s12178-021-09717-4 - DOI - PubMed - PMC
    1. Salmond S, Dorsen C (2022) Time to reflect and take action on health disparities and health inequities. Orthop Nurs 41(2):64–85. https://doi.org/10.1097/NOR.0000000000000828 - DOI - PubMed - PMC
    1. Summers MA, Matar RN, Denning JR, Dixon TL, Ramalingam WG, Asghar FA, Grawe BM (2020) Closing the gender gap: barriers to success for recruitment and retention of the female orthopaedic surgery applicant. JBJS Rev 8(5):e0211. https://doi.org/10.2106/JBJS.RVW.19.00211 - DOI - PubMed
    1. Tileston K (2023) CORR Insights(R): Interpersonal interactions and biases in orthopaedic surgery residency: do experiences differ based on gender? Clin Orthop Relat Res 481(2):379–381. https://doi.org/10.1097/CORR.0000000000002512 - DOI - PubMed

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