The Impact of Total Joint Arthroplasty on Sexual Function in Young, Active Patients

Patients experience mixed results with respect to sexual quality and frequency after total knee arthroplasty: a systematic review

“…When assessing differential findings in the proportion of patients who experienced increases and decreases in the quality/frequency of sex after surgery, Klit et al ,16 17 the study with the shortest follow-up time (12 months), reported the highest proportion of patients who experienced a decrease in sexual quality/frequency (32%) and the lowest proportion that experienced an increase (6%). This explanation is corroborated by findings by Nunley et al 18 and Nordentoft et al ,49 which demonstrated a greater loss in sexual activity and greater risk of erectile dysfunction with increasing age, and findings from Kazarian et al ,62 which demonstrated that sex-related outcomes continue to improve >1 year after surgery.…”

“…Nunley et al 18 retrospectively administered specialised questionnaires over the telephone to postoperative TKA patients in a multicentre study assessing the impact of surgery on sexual activity in young active patients, with an average age of 54.2 and a maximum age of 60. Surveys were administered by a third-party call centre, and focused on assessing sexual quality, frequency and limitations.…”

“…Nunley et al 18 determined that 84% (430) of patients reported returning to sexual activity, while 2% (8) of patients reported that they had not returned to sexual activity as a result of their knee. Sixty-six per cent (275) of patients reported having the same amount of sex, 10% (40) reported having less sex and 25% (103) reported having more sex.…”

“…Findings demonstrate that 50%–77% of patients should expect no change in the quality/frequency of sex as a result of TKA, and that 6%–44% should expect an increase16–18 49 62 (table 4). Improvements in the frequency and quality of sex can be attributed to decreased pain (99% and 98%, respectively), greater mobility (95% and 92%, respectively) and decreased apprehension about the knee during sex (70% and 61%, respectively) 18. After TKA, patients will likely experience diminished difficulty kneeling on the afflicted knee during sex, which may be accompanied by improvements in positional liberty.…”

Editor's Spotlight/Take 5: High Rates of Interest in Sex in Patients With Hip Arthritis

“…This month in CORR 1 , orthopaedic patients-young [12], young at heart [15], and older-tell us ''it'' matters. Even patients with the most severe kinds of orthopaedic disability report that sexual activity is both possible and important to them [14].…”