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How was it for you - sexual health

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Sr Bonesmartie
Aug 7, 2011
United Kingdom United Kingdom
This is, I think, an interesting comment on post-operative care!

Study explores link between total hip and knee arthroplasty and sexual health
  • Orthopedics Today, September 2012
BERLIN — In patients with degenerative osteoarthritis whose condition impacted their sexuality, researchers found that total hip and total knee arthroplasty improved their sexual self-image and activity.
"Our study shows that about 91% of patients had psychological problems and 64% had physical problems in sexuality because of arthritis," Parthiv Rathod, MD, said during his presentation at the 13th EFORT Congress 2012. "Overall, 46% of responders noted improvement in sexual activity after total hip or knee arthroplasty. In those patients who reported that their sexual activity was affected before surgery, more than 80% noticed improvement after surgery."
He also noted the rate of improvement was greater in patients with total hip arthroplasty (THA) as compared to total knee arthroplasty (TKA).
Prospective study
Rathod and colleagues mailed preoperative and 6-month and 1-year postoperative questionnaires to 392 adult patients with degenerative osteoarthritis (OA) who underwent THA or TKA performed by two surgeons at a single center. Of 134 patients who completed the preoperative questionnaires, 103 patients also returned the 6-month questionnaire and 65 responded to the 1-year questionnaire. Investigators excluded patients with other significant medical illnesses, psychological disorders and genital tract illnesses or abnormalities. Patients included in the study had an average age of 57.7 years. There were 71 women and 63 men. There were 88 patients who underwent THA and 46 patients who underwent TKA.
The researchers found that OA affected the general well-being in 91% of patients preoperatively, with 57% reporting that the condition impacted their self-esteem. In addition, nearly half of all patients noted that OA altered their sexual self-image.
A comparison with postoperative questionnaires revealed that general well-being improved in 84% of patients after surgery and self-esteem increased in 68%. Sexual self-image improved in 55% of patients following surgery.
The research also revealed that OA interfered with 39% to 59% of patients’ sexual activities including orgasm, desire and libido.
"In those patients who were affected before surgery, improvement occurred in 68% to 84% in frequency, duration of sexual activity and occurrence of orgasm," Rathod said. However, he noted that 16% of patients reported a decrease in the frequency and duration of sex after surgery, mainly due to the fear of damaging the replaced joint.
Pain, self-image
Most patients reported pain with pressure in the affected joint as the most common cause of decreased sexual activity before surgery. Patients also said preoperative stiffness, loss of libido, difficulty with sexual positions and fatigue during sex decreased sexual activity. Patients undergoing THA reported the groin as the most common site of pain during sexual activity before surgery, while patients undergoing TKA reported the medial aspect of the knee as the most common site.
"In most patients, neither analgesics nor massage relieved this pain," Rathod said.
When assessing self-image, researchers found 57% of patients were unhappy with their postures and 87% disliked their walking patterns, according to Rathod. Postoperatively, posture improved in 46% and walking pattern improved in 70%.
Of the patients, 91% experienced sexual difficulties due to psychological problems and 64% had sexual difficulties due to physical problems, Rathod said.
The researchers noted that the low response rate, potential for patients to misunderstand study questions and the fact that investigators did not correlate their results to routine functional outcome scores limited their study.
"Sexuality is a definite concern of patients with arthritis regardless of age or gender," Rathod said. "Total hip and knee arthroplasty improved sexual function in a significant number of patients. In order to completely evaluate patient satisfaction, it is important to incorporate elements of sexuality in our routine evaluation." – by Renee Blisard Buddle
  • Deshmukh A, Rathod P, Ranawat A, Rodriguez J. A prospective study evaluating influence of primary total hip and knee arthroplasty on sexual function. Paper #12-4389. Presented at the 13th EFORT Congress 2012. May 23-25. Berlin.
For more information:
  • Parthiv Rathod, MD, can be reached at the Center for Joint Preservation and Reconstruction, North Shore LIJ/Lenox Hill Hospital, 100 East 77th Street, New York, NY 10075; email: drparthivrathod@gmail.com.
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