BENGALURU: As the debate over gender differences in knee replacement surgeries moves from implant design to patient experience, doctors say expectations from surgery remain largely the same for men and women.The change in perspective was discussed at the Bangalore Orthopedic Society’s 29th annual conference, BOSCON 2026, held on Saturday, where physicians highlighted that outcomes are influenced less by gender and more by when and how patients access care.“The basic question is simple – what does any patient want from a knee replacement?” said Dr Pratima Khincha, consultant orthopedic surgeon at Khincha Orthopedic Centre. “Relief from pain, the ability to walk independently, climb stairs, return to work, and ultimately improve quality of life with as little medication as possible.” These expectations, he said, are universal.However, data shows that women often arrive later for surgery than men, typically with more advanced disease and greater disability. “By the time they come to us, their condition is often more advanced, and this is reflected in the results as well,” Dr. Khincha said.One of the main reasons for this is the decision making process. Many women are not the primary decision makers when it comes to surgery. “When patients are not the primary decision makers, it can impact their motivation and recovery. The ideal patient is one who chooses surgery for himself,” he said.Differences in perception also emerge. Doctors note that women are more apprehensive about post-operative pain, while men often focus on regaining pre-surgery activity levels. However, both share concerns about the risks and existing health conditions.On implant design, Dr Srishti Patil, consultant orthopedic and joint replacement surgeon at Sparsh Hospital, said gender alone should not dictate the choices. “Every knee is different—not just women’s knees,” he said. While anatomic differences exist — including issues like femoral overextension and anterior overextension that are commonly seen in women — he said the variability is wide across all patients. “Although gender-specific designs attempted to address this, these changes have not translated into meaningful clinical benefits,” he said.“We don’t fail because of gender. We fail because we ignore morphology,” said Dr. Chandrashekhar C, senior joint replacement surgeon at DHEE Hospital, adding that anatomical differences were oversimplified in earlier implant designs.He said the field is moving toward a phenotype-based approach, where treatment is tailored to each patient’s anatomy. “It’s no longer about male versus female transplants. It’s about understanding each patient’s anatomy and planning accordingly,” he said.