Background: 

Stereotypes may prevail, but little is known about the influence that the sex of an orthopaedic surgeon may have on outcomes. In a recently published study, there were no differences in the rate of adverse events following total hip arthroplasties (THAs) performed by female or male orthopaedic surgeons. The objective of the present study was to investigate whether there was any difference in adverse events within 90 days following a primary THA performed by either a male or female surgeon in Sweden.

Methods: 

A retrospective study was performed to evaluate primary THAs performed for osteoarthritis between 2008 and 2016 at 10 hospitals in western Sweden. Local hospital data were linked with the Swedish Hip Arthroplasty Register (SHAR) and with a regional patient register. Data collected from local hospitals and the SHAR included surgeon-related information (e.g., sex, annual volume, and level of training) and patient-related information (e.g., age, sex, and Elixhauser comorbidity index). Adverse events were retrieved from the regional patient register. The definition of adverse events followed the SHAR definition of adverse events. Mixed models were used to investigate the impact of surgeon sex on adverse events.

Results: 

A total of 11,993 primary THAs were performed by 200 surgeons, of whom 17.5% were women. The proportions of adverse events within 90 days were similar for female (6%) and male (7%) surgeons. No association was found between surgeon sex and adverse events (adjusted odds ratio, 0.72; 95% confidence interval, 0.52 to 1.00) when all surgeons (both attendings and residents) were included in the analysis. A sensitivity analysis that included attendings only yielded similar results (adjusted odds ratio, 0.88; 95% confidence interval, 0.60 to 1.29).

Conclusions: 

Despite a small tendency toward lower rates of adverse events at 90 days after THAs performed by female surgeons, there was no significant association between surgeon sex and the risk of adverse events following THA.

Level of Evidence: 

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

---

外科医生性别对初次全髋关节置换术后不良事件的影响：一项针对瑞典公立医院 11,993 例手术和 200 名外科医生的注册研究

背景： 

刻板印象可能会盛行，但对于整形外科医生的性别可能对结果的影响知之甚少。在最近发表的一项研究中，女性或男性整形外科医生进行全髋关节置换术 (THA) 后的不良事件发生率没有差异。本研究的目的是调查瑞典男性或女性外科医生进行初次 THA 后 90 天内不良事件是否有任何差异。

方法： 

进行了一项回顾性研究，以评估 2008 年至 2016 年间在瑞典西部的 10 家医院对骨关节炎进行的原发性 THA。当地医院数据与瑞典髋关节置换术登记册 (SHAR) 和地区患者登记册相关联。从当地医院和 SHAR 收集的数据包括外科医生相关信息（例如，性别、年产量和培训水平）和患者相关信息（例如，年龄、性别和 Elixhauser 合并症指数）。从区域患者登记中检索不良事件。不良事件的定义遵循 SHAR 对不良事件的定义。混合模型用于调查外科医生性别对不良事件的影响。

结果： 

200 名外科医生共进行了 11,993 次初次 THA，其中 17.5% 为女性。女性 (6%) 和男性 (7%) 外科医生在 90 天内的不良事件比例相似。当所有外科医生（主治医生和住院医师）都被纳入分析时，未发现外科医生性别与不良事件之间存在关联（调整优势比，0.72；95% 置信区间，0.52 至 1.00）。仅包括主治医师的敏感性分析产生了相似的结果（调整优势比，0.88；95% 置信区间，0.60 至 1.29）。

结论： 

尽管女性外科医生进行 THA 后 90 天的不良事件发生率较低，但外科医生性别与 THA 后不良事件风险之间没有显着关联。

证据等级： 

治疗三级。有关证据级别的完整描述，请参见作者说明。