Sex Differences in Complications Following Total Hip Arthroplasty: A Population-Based Study.

BACKGROUND: The relationship between sex and outcomes, especially complications, after total hip arthroplasty (THA) has not been well established. This study aimed to identify if patient biological sex significantly impacted complications after THA in Ontario, Canada. METHODS: A population-based retrospective cohort study of patients undergoing primary THA in Ontario from April 1, 2015 to March 31, 2020 was conducted. The primary outcome was major surgical complications within a year postsurgery (a composite of revision, deep infection requiring surgery, and dislocation). Secondary outcomes included the individual component of the composite primary outcome and major medical complications within 30 days. Proportional hazards regression calculated the adjusted hazards ratio for major surgical complications in men relative to women, adjusting for age, comorbidities, neighborhood income quintile, surgeon and hospital volume, and year of surgery. RESULTS: A total of 67,077 patients (median age 68 years; 54.1% women) from 61 hospitals were included; women were older with a higher prevalence of frailty. Women had a higher rate of major surgical complications within 1 year of surgery compared to men (2.9 versus 2.5%, adjusted odds ratio 1.19, 95% confidence interval 1.08 to 1.33, P = .0009). Conversely, men had a higher risk for medical complications within 30 days (6.3 versus 2.7%, P < .001). CONCLUSIONS: Observable sex disparities exist in post-THA complications; women face surgical complications predominantly, while medical complications are more prevalent in men. These insights can shape preoperative patient consultations. LEVEL OF EVIDENCE: Level III.

Effects of creatine on body composition and strength gains after 4 weeks of resistance training in previously nonresistance-trained humans.

This study examined the effects of Cr supplementation on muscle strength in conjunction with resistance training in nonresistance-trained males utilizing strategies previously reported in the literature to help optimize muscle CR uptake. Nineteen nonresistance-trained males underwent 4 weeks of resistance training (3 days x week(-1)) while assigned to Cr (20 g x d(-1) Cr + 140 g x d(-1) glucose) for 7 days (loading), followed by 5 g x d(-1) Cr + 35 g x d(-1) glucose for 21 days (maintenance; n = 9) or placebo (160 g x d(-1) glucose [loading] followed by 40 g x d(-1) [maintenance; n = 10]). In subjects classified as "responders" to Cr on the basis of body mass changes (n = 7), the magnitude of change in 180 degrees x s(-1) isokinetic (p = .029) and isometric (p = .036) force was greater compared to the placebo group. A positive correlation was found between changes in body mass and 180 degrees x s(-1) isokinetic (loading: r = 0.68, p = .04; maintenance: r = 0.70, p = .037) and isometric (loading: r = 0.82, p < .01) force. Estimated Cr uptake was also positively correlated with changes in isometric force (r = 0.71, p = .033). These results indicate that Cr supplementation can increase muscle strength (allied with 4 weeks of strength training) but only in subjects whose estimated Cr uptake and body mass are significantly increased; the greater the Cr uptake and associated body mass changes, the greater the performance gains.