Baseline Characteristics Explain Sex Differences in Primary Total Knee Arthroplasty Outcomes: A Prospective Multicenter Study with 4-Year Follow-Up

Sex was not an independent predictor of TKA outcomes once baseline characteristics and preoperative scores were accounted for. Women present with less favorable preoperative profiles, including worse pain and function, higher body mass index, and greater prevalence of anxiety and depression. Improving preoperative status in women through earlier referral, optimized management of affective disorders, and targeted interventions may help narrow disparities in TKA outcomes.