1st Department of Orthopaedics, P. & A. Kyriakou Children's Hospital, Athens, Greece.
Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Int Orthop. 2023 Sep;47(9):2143-2171. doi: 10.1007/s00264-023-05876-w. Epub 2023 Jul 12.
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.
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.
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.
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.
已有多项研究探讨了性别平等挑战以及改善女性代表性和管理的方法。与其他外科专业相比，矫形外科医生和患者的性别平等程度较低。本系统评价总结了这些发现，并强调了矫形外科手术的性别不平等。
对 PubMed、Embase 和 Cochrane 数据库进行检索，以提取调查矫形外科性别差距的人类研究，试图突出矫形外科面临的平等挑战。纳入的研究包含患有性别被证实为风险因素的合并症的患者和孕妇。
本系统评价纳入了 59 项研究，涉及 692435 人（女性/男性平均比例：4.44），研究时间跨度为 1987 年至 2023 年。关于目标人群，35 项（59.32%）研究侧重于患者，而 24 项（40.68%）研究侧重于医生。矫形外科被描述为对女性外科医生或运动医学主要医生来说不友好的职业领域，而女性在矫形学的学术领域普遍代表性不足。关于患者，女性性别既是影响退行性疾病患病率和重建矫形手术结果的风险因素，也是预后因素。女性是多种运动损伤的风险因素，并影响导致 ACL 重建的发病机制。在脊柱外科方面，女性接受手术建议的可能性较小，而这种建议则强调了疾病的严重程度进展。
性别差异会影响矫形科医患-医疗保健系统的互动。认识到偏见及其模式有助于改善现状。通过防止偏见、包容和平等，医生可以拥有一个无偏见、宽容和平等的工作场所，而医疗保健系统可以为患者提供最佳治疗。
