The Impact of Sex Differences in Musculoskeletal Medicine

Musculoskeletal health is one of the areas of medicine in which differences between males and females are most striking.   Although males have a higher incidence of traumatic injuries, females are disproportionately disabled by musculoskeletal conditions such as adolescent spinal deformities, ACL injuries, osteoarthritis, and osteoporotic fragility fractures. Therapeutic modalities have been based on studies of male populations or young adult male animals, or the studies do not specify the sex of the population. Understanding of these conditions as they occur throughout the human life span thus has been limited with respect to sex. Fostering research The American Academy of Orthopaedic Surgeons (AAOS) Women’s Health Issues Advisory Board (WHIAB) seeks to advocate, advance, and serve as a resource on sex and gender differences in musculoskeletal health and research. Since females suffer from disease in different ways than males, recognizing sex-related differences is critical to optimizing patient care. In an effort to foster the mission of the WHIAB, the Journal of Orthopaedics is featuring 10 articles which highlight research focused on sexual dimorphism in orthopaedics. Sexual dimorphism is considered a priority within the spectrum of orthopaedic research as demonstrated within these articles, including research in basic science, anatomy, biochemistry, hormonal, physiological, neuromuscular, and clinical form and function of bone and soft tissues.

Improved Healthcare Delivery

An approach tailored to the separate biologic needs of females and males through basic science and clinical research will enable healthcare providers to address each patient based on his or her individual biologic needs. Interventions, therapeutic modalities, and best future practices based on sexual dimorphism will improve healthcare delivery for all patients.

Sex-Related Differences in Neuromuscular Control: Implications for Injury Mechanisms or Healthy Stabilisation Strategies?
Teresa E. Flaxman, Andrew J. J. Smith, and Daniel L. Benoit

Effects of ACL reconstruction surgery on muscle activity of the lower limb during a jump-cut maneuver in males and females
Margaret S. Coats-Thomas, Daniel L. Miranda, Gary J. Badger and Braden C. Fleming

Knee rotation in healthy individuals related to age and gender
Per O. Almquist, Charlotte Ekdahl, Per-Erik Isberg and Thomas Fridén

Effect of Age and Gender on Cell Proliferation and Cell Surface Characterization of Synovial Fat Pad Derived Mesenchymal Stem Cells
Emma Fossett, Wasim S. Khan, Umile Giuseppe Longo, and Peter J. Smitham

Morphology of the Proximal Femur Differs Widely with Age and Sex: Relevance to Design and Selection of Femoral Prostheses
David S. Casper, Gregory K. Kim, Javad Parvizi, and Theresa A. Freeman

Gender and condylar differences in distal femur morphometry clarified by automated computer analyses
Kang Li, Evan Langdale, Scott Tashman, Christopher Harner and Xudong Zhang

Viscoelastic properties of human cortical bone tissue depend on gender and elastic modulus
Ziheng Wu, Timothy C. Ovaert and Glen L. Niebur

Gender Differences in Both Active and Passive Parts of the Plantar Flexors Series Elastic Component Stiffness and Geometrical Parameters of the Muscle-Tendon Complex
Alexandre Fouré , Christophe Cornu, Peter J. McNair, and Antoine Nordez

Age, sex, body anthropometry, and ACL size predict the structural properties of the human anterior cruciate ligament
Javad Hashemi, Hossein Mansouri, Naveen Chandrashekar, James R. Slauterbeck, Daniel M. Hardy and Bruce D. Beynnon

Gender differences in 3D morphology and bony impingement of human hips
Ichiro Nakahara, Masaki Takao, Takashi Sakai, Takashi Nishii, Hideki Yoshikawa and Nobuhiko Sugano

SOURCE:  Journal of Orthopaedic Research (JOR), in conjunction with the AAOS Women’s Health Issues Advisory Board, published a special virtual issue highlighting articles that focus on musculoskeletal sex differences.

Edited by: Laura M. Bruse Gehrig, MD, and the chairs the AAOS Women’s Health Issues Advisory Board.  It is available online at