OSTEOARTHRITIS IN WOMEN: ARE THERE ANY DIFFERENCES? Review

Relevance. Female gender is known to be a major risk factor for osteoarthritis (OA). In addition, women with OA are characterized by some differences in the context of etiopathogenesis, clinical course and prognosis, and the question of clarifying the causes of these differences remains relevant. Objective: to review the literature data on the epidemiological, etiopathogenic and clinical features of OA in women, as well as the peculiarities of treatment and prognosis based on gender. Materials and methods. Analysis of scientific publications in the international electronic scientometric database PubMed using keywords "osteoarthritis", "women", "gender", "estrogens" over the period 1989-2019 years. Results. The incidence of OA is on average almost twice as high among women compared with men. Smoking, alcohol and heavy exercise are significant risk factors of OA for men, while the role of genetic factors is more significant for women. High concentrations of estradiol in women are associated with a lower degree of cartilage destruction, less significant productive synovitis and a lower rate of total arthroplasty. Women with knee OA are characterized by significantly higher pain intensity during walking and knee extension. The strength of quadriceps femoris muscle is significantly lower in women than in men, regardless of the severity of OA. Women with OA are characterized by a higher concentration of C-reactive protein, which is associated with a larger number of painful joints. Women are more likely than men to take non-steroidal anti-inflammatory drugs and use topical agents. The frequency of total arthroplasty among women is much higher, but early rehabilitation after it is relatively more favorable than in men. Conclusions. Sex hormones, genetic factors, lower extremity muscle strength, anatomical and kinematic features of the knee joints play an important role in the etiopathogenesis of OA in women. Women with OA are characterized by more intense and diffuse character of pain, more significant functional impairments compared to men.