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More Knee Replacement Recommended for Men, Not Women

I just read about a study where researchers found that doctors recommended knee replacement more often for females than males, who had identical levels of knee osteoarthritis.

One of the commenting physicians said:
“Women are less likely to get this very effective surgical procedure,” Dr. Wright said. “They should be more aggressive in challenging doctors, especially by getting second opinions.”

Have you had experience with knee replacement surgery for osteoarthritis? Is it an effective, yet aggressive, surgical procedure? Are there other effective, yet less aggressive procedures?