Osteoarthritis (OA) of the hip or knee, affecting millions of Americans each year, is known to limit sexual activity. New research presented at the 2013 annual meeting found that total hip replacement (THR) and total knee replacement (TKR) surgery improved sexual function in 90% of patients. Higher rates of improvement were seen after THA than TKA, Parthiv A. Rathod, MD, from Flushing, New York, and colleagues noted.
"This study emphasizes the importance of including sexuality and sexual activity as an important component of evaluating the functional outcome of total hip and total knee [replacement]," according to principal investigator Jose A. Rodriguez, MD, Orthopaedic Surgeon and Chief, Center for Joint Preservation and Reconstruction at Lenox Hill Hospital in New York. Hip or knee replacement does "offer improvement in sexual activity and overall sexuality to patients after surgery, especially if (sexuality) is affected before surgery," he added.
In this prospective study, the investigators reviewed the data of patients younger than 70 years scheduled for primary THR or TKR for OA between February 2009 and May 2011. Each participant was asked to complete questionnaires prior to surgery, 6 months postsurgery, and at 1-year postsurgery.
Overall, 116 patients completed preoperative surveys and 65 patients completed both 6-month and 1-year postsurgery. The mean age of the patient population was 57.7 years; 69 patients were men and 78 women. Sixty-seven percent of the patients reported physical problems with sexual activity prior to surgery, including pain and stiffness, and 91% of the patients reported psychological issues related to their OA such as general well-being and sexual self-image. Postoperative surveys indicated that 42% of patients had an improvement in libido, 36% increased intercourse duration, and 41% increased intercourse frequency. In addition, 84% of patients reported improvement in their general well-being and 55% in their sexual self-image. Sixteen percent of patients reported that their joint replacement surgery adversely affected their sexual function, primarily due to a fear of damaging the replaced joint.
Overall, 90% of THR and TKR patients reported improved overall sexual function, with a slightly higher rate of improvement after THR than TKR. More women reported improvement after THR than men.
As some patients reported a fear of damaging their new hip or knee as a reason to limit sexual activity following surgery, "It is important for the healthcare provider to discuss the functional status of each patient in terms of sexual activity and overall sexuality," Dr. Rodriguez emphasized. "This could be in the form of a one-on-one discussion with patients, or (the provision) of information booklets, or both if necessary, to effectively determine and address this fear."