Sex After Hip Surgery: Advice That Patients May Not Receive

Neil Chesanow

Disclosures

November 30, 2015

Surgery to Rekindle Sexual Activity

Claudette Lajam, MD, assistant professor of orthopedic surgery at New York University's Langone Medical Center, has an anecdote from her days as a resident at the Mayo Clinic in Rochester, Minnesota, posted on her website.

For years, a farmer in his 70s with severe arthritis of the hip had been coming to the clinic for treatment, accompanied by his wife, who seldom spoke during their visits.[1] Each time, a total hip replacement (THR) was recommended, and each time he refused, saying that he would "live with the pain."

Then one year he had a change of heart. When THR was again recommended, he and his wife were eager to know how soon the surgery could be performed.

"Why, after all of these years with horrible pain and loss of motion in your hips, have you decided to have a hip replacement now?" Dr Lajam was curious to know. The farmer and his wife looked at each other and smiled.

"Well, doctor," his wife replied, "we've discovered Viagra®!"

A Talk That Many Orthopedists Don't Have

Over 1 million THRs are performed every year worldwide,[2] nearly 303,000 in the United States alone.[3] Decreased pain, increased mobility, and improved quality of life factor into the decision.[2]

Yet resumption of sexual activity is often ignored as a key quality of life goal.

"Sexual activity is a key component of quality of life," note Rotem Meiri and colleagues in "Sexual Function Before and After Total Hip Replacement," a 2014 literature review that appeared in the journal Sexual Medicine, where, unfortunately, few busy orthopedists are likely to see it.[2]"However, little is known about how THR affects sexual functioning or the extent to which health care providers address sexuality in THR patients."

In a 2013 study in which 116 men and women, 58.6 years of age on average, completed questionnaires on their sexual activity after total hip arthroscopy (TKA) or total knee arthroscopy (TKA), 90% reported improved overall sexual function, including frequency and duration.[4] "Sexual function needs to be included in routine evaluation of patients after THA and TKA," the authors concluded.

However, the subject of sex often isn't broached either before or after THR.

"I never want to see someone's intimacy with a partner destroyed because of a joint problem," says orthopedic surgeon Jose A. Rodriguez, MD, director of the Center for Joint Preservation and Reconstruction at Lenox Hill Hospital in New York, and the study's chief investigator.[3] "Sexual function needs to be discussed with patients when we make routine evaluations. I've found most patients to be very receptive to talking about it."

Dr Rodriguez says he decided to do the study because he knows doctors who aren't comfortable discussing sex with patients.[3]

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