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Sex differences in participation restriction which is the final domain of disablement pathway is not known. No data from developing countries exist on sex differences in disability levels at the time of <jats:styled-content style=\"fixed-case\">TKA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a cross\u2010sectional analysis of 240 patients (188 women; 72 men) scheduled for <jats:styled-content style=\"fixed-case\">TKA<\/jats:styled-content>, impairment (pain, symptoms, quadricep muscle strength, and knee range of motion [<jats:styled-content style=\"fixed-case\">ROM<\/jats:styled-content>]), activity limitation (self\u2010reported and objective performance\u2010based measurements), and participation restriction were compared. Multivariable regression analyses were used to adjust for key sociodemographic and clinical characteristics. Associations between impairments and participation restriction were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with men, women were more likely to have higher levels of impairment (knee injury and osteoarthritis outcome pain score adjusted mean difference [<jats:styled-content style=\"fixed-case\">aMD<\/jats:styled-content>]: \u22126.9 [95% confidence interval {<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>} \u221213.7 to \u22120.18]; flexion <jats:styled-content style=\"fixed-case\">ROM<\/jats:styled-content> of less than 100\u00b0 adjusted odds ratio: 5.7 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.6\u201020.3]; and 36% lower muscle strength [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 24%\u201049%]) and lower objectively measured functional ability (walking speed <jats:styled-content style=\"fixed-case\">aMD<\/jats:styled-content>: \u22120.12 m\/s [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u22120.23 to \u22120.02]; stair climbing time <jats:styled-content style=\"fixed-case\">aMD<\/jats:styled-content>: 9.5 s [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.5\u201017.5]). Participation restriction was higher in women compared with men. Of the impairment measures (pain, <jats:styled-content style=\"fixed-case\">ROM<\/jats:styled-content>, and muscle strength), pain contributed to participation restriction in both sexes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrated higher levels of disability in women than in men at the time of <jats:styled-content style=\"fixed-case\">TKA<\/jats:styled-content>. Effect of pain on participation restriction was higher compared with muscle strength and <jats:styled-content style=\"fixed-case\">ROM<\/jats:styled-content>. Evidence of delay in decision\u2010making to undergo <jats:styled-content style=\"fixed-case\">TKA<\/jats:styled-content> and reasons for delay need to be studied specifically in the context of lower middle\u2013income countries.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr2.11137","type":"journal-article","created":{"date-parts":[[2020,5,9]],"date-time":"2020-05-09T07:33:59Z","timestamp":1589009639000},"page":"309-319","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Higher Disability in Women Than Men Scheduled for Total Knee Arthroplasty for Degenerative Osteoarthritis: A Cross\u2010Sectional Analysis From India"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3044-0560","authenticated-orcid":false,"given":"Niveditha","family":"Devasenapathy","sequence":"first","affiliation":[{"name":"Indian Institute of Public Health\u2010Delhi Public Health Foundation of India, New Delhi, India, and Deakin University Geelong Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajesh","family":"Malhotra","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanchan","family":"Mittal","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhavuk","family":"Garg","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vijay","family":"Kumar","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjay","family":"Zodpey","sequence":"additional","affiliation":[{"name":"Deakin University Victoria Geelong Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hardik","family":"Dogra","sequence":"additional","affiliation":[{"name":"Deakin University Victoria Geelong Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralph","family":"Maddison","sequence":"additional","affiliation":[{"name":"Deakin University Victoria Geelong Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel L.","family":"Belavy","sequence":"additional","affiliation":[{"name":"Deakin University Victoria Geelong Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,5,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32154-2"},{"key":"e_1_2_8_3_1","unstructured":"Institutes for Health Metrics and Evaluation.Global burden of disease: Study data. 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