Special Issue and Review Article on Sex Differences

We are excited that following a call for a Special Issue on sex differences in osteoarthritis:
https://www.sciencedirect.com/special-issue/10VMS3T8C3L with guest editors Dieuwke Schiphof (Erasmus, Rotterdam) and Tristan Maerz (University of Michigan), our two review articles on the anatomical and imaging aspects of this topic (i.e. morpho-types) are now published.

READ on sex-differences in radiographic joint space width (JSW), meniscus & ligaments, cartilage morphology, composition & deformation, and articular tissue response to treatment in the review on articular tissue anatomy in the Special Issue OAC: https://pubmed.ncbi.nlm.nih.gov/38871022/

…and then on bone size & shape, subchondral & subarticular bone, synovial membrane & infra-patellar fad-pad (IPFP), muscle & adipose tissue, and eventually peri-articular tissue response to treatment in the the second review on peri-articular tissue anatomy in OAC OPEN:  https://pubmed.ncbi.nlm.nih.gov/38946793/

• Did you know that humans exhibit greater evolutionary homogeneity than most other species, since their genetic repertoire originates from a small population of <1500 breeding individuals, a “bottleneck” in evolution that lasted >100.000 years, bringing human ancestors close to extinction?
• As authors, we are aware that classifications of human sex cannot be reduced to female/male. However, given lack of literature on non-binary individuals, this review article is limited to the analysis of sexual dimorphism, “morpho-types” around which variability clusters.
• Women demonstrate more severe manifestations of musculoskeletal disorders, the inter-sex-disparity increasing with age. Knee and hand osteoarthritis are more prevalent in women, particularly symptomatic osteoarthritis.
• It remains currently enigmatic to what extent sex-differences in osteoarthritis incidence originate from sexual dimorphism in joint anatomy, potentially exposing women to greater vulnerability.

From reviewing the literature, we conclude that female joints may be anatomically (and biomechanically) disadvantaged and at greater risk of incident knee osteoarthritis.

We reproach that only few publications mention the term “sex” in their title or abstract, data mostly “hidden” in the results.

Sex should not only be treated as a confounder, but statistical analysis should be undertaken in sex-specific strata. Sex-comparison is often confounded by demographic or disease factors.

Only few papers reported sex-differences in structure modifying interventions, this unfortunately not being the standard in clinical trials.

Sex-specific healthy reference data, and public data bases of (peri-) articular tissue properties at various developmental stages are lacking and urgently needed for comparison

The “one_size|sex fits_all” approach must be abandoned in scientific reporting. Differences between women, men, and otherwise categorized individuals must be recognized, in research as well as in clinical practice.

This approach should be pursued per self-commitment of the scientific-community, and adopted into official editorial policies of scientific journals and text books for full implementation.

We are tremendously grateful to the many colleagues who supported us in identifying and reporting these data:

Article 1 (OAC Special Issue): Gerard Ateshian, Francis Berenbaum, Flavia Cicuttini, Martin Englund, Ali Guermazi, David Hunter, Mylène Jansen, Gabby Joseph, Thomas Link, Malcolm Logan, Michael Nevitt, Frank Roemer

Article 2 (OAC OPEN): Kim Bennell, Francis Berenbaum, Mikael Boesen, Alan Brett, Ali Guermazi, David Hunter, Gabby Joseph, Olga Kubassova, Virginia Kraus, Thomas Link, Steve Messier, Ralph Mueller, Michael Nevitt, Andrew Pitsillides, Frank Roemer, Kathryn Stok