Gender differences of venous thromboembolism risk after total hip and total knee arthroplasty: a meta-analysis

We performed a meta-analysis to evaluate gender differences of venous thromboembolism (VTE) risk after total hip (THA) and total knee arthroplasty (TKA). We searched PubMed and Web of Knowledge from their beginning to 25 July 2015. Pooled odds ratio (OR) and 95 % confidence interval (CI) for VTE risk were calculated. Twenty studies with 7,892,585 patients were included in our study. The VTE incidence ranged from 0.27 to 61.0 %. The sex ratio (male/female) was 0.623 (3,016,648/4,839,785) in no VTE group versus 0.492 (11,926/24,226) in VTE group. The pooled OR was 1.184 (95 % CI 1.070-1.310; Z = 3.28, P = 0.001). The Begg's test (z = 1.46, P = 0.144) and the Egger's test (t = 0.58, P = 0.571), and the funnel plot suggested there was no significant publication bias. Sensitivity analysis by omitted a study with largest simple size showed the pooled OR was 1.166 (95 % CI 1.051-1.294; Z = 2.91, P = 0.004) by random-effects model. Meta-regression showed VTE risk was not related with THA and TKA incidence (t = 0.35, P = 0.732). Our meta-analysis showed female patients have slightly higher risk of VTE than male patients after THA and TKA.