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Female gender is associated with a higher prevalence and severity of OA. large meta-analysis demonstrated a greater risk in women for prevalent and incident knee and hand OA as well as incident hip OA compared with men. In addition, women were found to have more severe knee OA than men, particularly after menopause. The Framingham Knee OA Study reported a 1.7 times higher incidence of OA of the knee in women compared with men. Women were estimated to have a lifetime increased risk of symptomatic knee OA of 47 percent The reason for the increased risk of OA in women remains unclear, but it may be related to hormones, genetics, or other undetermined factors.