Sport and sexual recovery after total hip arthroplasty in young adults: a retrospective cohort study

Abstract

Introduction : Total Hip Arthroplasty (THA) is the main treatment for end-stage degenerative hip arthrosis in the elderly, while became increasingly performed as treatment of secondary arthrosis in younger patients, a population at high functional requests in terms of resumption of physical activity and resumption of sexual activity. This study evaluates the physical, sports recovery and the sexual quality of life in young patients undergoing primary THA. Materials and methods Patients undergoing primary THA aged between 18 and 45, operated in a 10 year timeframe, were selected. Demographic, clinical, and radiological data were collected. The Harris Hip Score (HHS) was assessed before and after the surgery. The UCLA Activity Score was collected, sport participation in pre and post-operative period was acquired. The quality of sexual activity (SQoL) before and after surgery was analysed through a qualitative questionnaire. Collected data were also compared on the surgical approach, namely Direct Anterior (DAA), Postero-Lateral (PL) and Direct lateral (DL). Results The population consisted of 242 THA implanted in 232 patients, including 143 males and 89 females, with an average age of 37.4. The mean follow-up period was 51.0 months, with a minimum of 2.9 months and a maximum of 122.6 months. Postoperatively, the average HHS was 90.29 ± 0.9 points, compared to 62.43 ± 1.34 points preoperatively (p < 0.001). The UCLA Activity Score in the postoperative period was 7.17 ± 0.17 matching to intermediate impact sport activity. The 64% of patients reported an improvement in SQoL after-surgery, 73% of which being females that show a significant improvement in SQoL compared to males (p = 0.046). By surgical approach comparison, DAA patients demonstrated better UCLA Activity Score (p = 0.037) and Return to sport (p = 0.027) compared to PL and DL. Conclusion Primary THA surgery in young adults can improve the level of physical activity and promote the involvement of subjects in moderate impact sports. Patients showed a better quality of sexual life compared to the preoperative period, an effect more evident in female patients.