Abstract
INTRODUCTION
Osteoarthritis (OA) of the hip and the knee has been found to affect sexual activity. Few retrospective studies have investigated the role of total hip replacement on sexual function. We designed a prospective study to evaluate the influence of total hip arthroplasty (THA) and total knee arthroplasty (TKA) on the physical and psychological aspects of sexuality of patients.
METHODS
Between April 2009 and April 2011, patients under 70 years of age scheduled for primary THA or TKA for OA were invited to anonymously participate in this study. All patients were recruited from the practices of 2 arthroplasty surgeons (at the same institution) by mailing the 2 questionnaires, 2 pre-paid self-addressed envelopes and a cover letter. Patients were instructed to mail back the pre-operative questionnaire prior to surgery and the post- operative questionnaire 6 months after surgery. Enrolled patients were also contacted after 1 year of surgery to fill a similar questionnaire. Responses were identified only by a unique code number on the questionnaire.
RESULTS
Out of 343 consecutive patients, 115 enrolled in the study by returning preoperative questionnaires. 95 of them returned 6 month questionnaires and 65 returned all questionnaires. The mean age of patients was 56.8 years (34–70) with 59 males and 56 females. 63.6% patients reported physical problems with sexual activity (pain 64%, different positions 52%, stiffness 30%, reduced libido 21%, inability to attain proper position 16%), and 91% reported psychological issues (general well-being 90%, sexual self-image 52%). Postoperatively, 46% reported increased intercourse frequency, 41% reported increased intercourse duration, 39% patients reported an improvement in libido, 84% had improvement in general well-being and 55% had improved sexual self-image. 19% patients reported fear of damaging replaced joint during sexual activity, while 7% patients reported their replacement surgery to adversely affect sexual function.
CONCLUSION
In 90% patients, THA or TKA improved overall sexual function. Patients with THA had better improvement in sexual function than patients with TKA. After THA, sexual activity improvement was significantly more in females than males.
