Sexual Function Improves Significantly after THA, TKA

More females report improvement

Osteoarthritis (OA) of the hip or knee, which affects millions of Americans each year, is known to limit sexual activity. According to the results of research presented in Scientific Poster 023, on display in Academy Hall B, total hip arthroplasty (THA) or total knee arthroplasty (TKA) surgery improves sexual function in 90 percent of patients.

The study involved 147 patients younger than age 70, who were scheduled to undergo primary THA or primary TKA. All patients agreed to complete three questionnaires: one before the surgery, one at 6 months after surgery, and one at 1 year after surgery. Sixty-five percent of patients returned all three surveys.

The group of patients included 68 men and 78 women; patients had a mean age of 57.7 years. More than two thirds of the patients reported physical problems with sexual activity prior to surgery. The problems reported (and the percentage of patients reporting that problem) were as follows:

  • pain (67 percent)
  • stiffness (36 percent)
  • reduced libido (49 percent)
  • inability to attain proper position (14 percent)

Nearly all participating patients (91 percent) reported psychological issues related to their OA. Of these patients, most (91 percent) reported diminished general well-being, and more than half (53 percent) reported diminished sexual self-image.

Following the surgery, 42 percent of patients reported an improvement in libido, 41 percent reported increased intercourse duration, and 41 percent reported increased intercourse frequency. Patients also reported improvement in general well-being (84 percent) and in their sexual self-image (55 percent).

A small group (16 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 percent of THA and TKA patients reported improved overall sexual function; THA patients reported a slightly higher rate of improvement than TKA patients. More female patients reported improvement after THA than male patients.

“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 arthroplasty,” said principal investigator Jose A. Rodriguez, MD, orthopaedic surgeon and chief of the 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,” said Dr. Rodriguez.

Because 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,” said Dr. Rodriguez. “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.”

Coauthors with Dr. Rodriguez on Poster P023, “Sexual Function Improves Significantly after Primary THA, TKA” include Parthiv A. Rathod, MD; Ajit J. Deshmukh, MD; and Amar S. Ranawat, MD.

Disclosures: Dr. Rodriguez—Smith & Nephew; Wright Medical Technology, Inc.; DePuy, A Johnson & Johnson Company; Exactech, Inc; Arthrex, Inc; Journal of Arthroplasty; Clinical Orthopaedics and Related Research (CORR), HSS Journal. Drs. Rathod and Deshmukh—no conflicts. Dr. Ranawat—DePuy, A Johnson & Johnson Company; Stryker; Mako, ConforMIS, Pipeline Medical, Convatec, Medtronic, Ceramtec, Journal of Arthroplasty, CORR, Journal of Bone and Joint Surgery.