Sex Differences in the Relationship Between Hand and Leg Dominance and Knee Osteoarthritis Laterality

Limited knowledge exists surrounding the relationship between hand and leg dominance and knee osteoarthritis (OA) laterality. The authors of this study characterized sex differences between hand and leg dominance and knee OA laterality in 100 adults undergoing unilateral primary total knee arthroplasty (TKA). A total of 455 electronic medical records (EMR) with primary unilateral TKA in the past 5 years at Atrium Health Wake Forest Baptist were reviewed. One hundred phone surveys were conducted to characterize self-reported hand and leg dominance preferences. Of 100 patients, there were 40 males and 60 females with a mean age of 73. There was no association between hand (p = 0.573) or leg (p = 0.121) dominance with ipsilateral TKA. Males showed contralateral associations for hand (p = 0.008) and leg (p = 0.004) dominance with TKA laterality. Females showed ipsilateral associations for both hand (p = 0.004) and leg (p < 0.001) dominance with TKA laterality. Understanding this relationship may improve the efficacy of future orthopaedic risk assessments, disease prevention recommendations, and targeted rehabilitation plans. (Journal of Surgical Orthopaedic Advances 35(2):086–090, 2026) Key words: hand dominance, leg dominance, osteoarthritis, total knee arthroplasty, sex differences