A retrospective study of changes in sexual behavior after total hip arthroplasty in individuals under 55 years old

Abstract

Introduction

Total hip arthroplasty is one of the most effective interventions to treat patients with end-stage hip arthritis. Although the outcomes of total hip arthroplasty have already been widely studied and most of the published results are positive, the dominant outcomes measures are focused on implant survivorship, patient mortality and complication rates. Quality of life assessment is regarded as a gold standard for outcomes measurement nowadays and was more frequently adopted in researches. However, in most of the study assessing the quality of life of patients undergoing total hip arthroplasty ignored the importance of quality of sexual life. Moreover, none of them are studying the Chinese population. In order to assess the quality of life of patients holistically, a study that focused on the quality of sexual life among Chinese population undergoing total hip arthroplasty is recommended. The aim of the present study is to investigate the changes in quality of sexual life in young Chinese patients undergoing primary total hip arthroplasty.

Methodology

The present study is a descriptive survey adopted a retrospective design and was conducted either as a phone interview or interview in person. 118 Patients who have undergone total hip arthroplasty at the Queen Mary Hospital are recruited from March 2012 to June 2012. Questionnaires assessing the pre-operation and post-operation sexual life and quality are administered. 118 subjects participated in the study finally.

Results

118 subjects participated in the present study. 35 of them reported to have no sexual life due to reasons other than the condition of their hip and were analyzed separately. 83 of the subjects were included in the analysis of changes in sexual life. Preoperatively 50.6% of subjects reported having severe to extreme sexual difficulty. 64 (78.0%) and 16 (19.5%) subjects reported the cause of sexual difficulty to be joint pain and joint stiffness respectively. 61 (73.5%) subjects believed the condition of their hip caused some degree of distress in the relationship with their partner preoperatively. 83.2% of subjects rated their level of sexual difficulty from minimal to mild after having total hip arthroplasty. 23 (28%) and 47 (57.3%) of subjects reported their post-operation sexual life experience to be better and much better respectively.

It is shown that greater joint pain (p<0.001) and stiffness (p=0.003) and lower Harris hip score (p=0.001) are significantly correlate with greater pre-total hip arthroplasty sexual difficulty, while only the range of motion of hip remained to be negatively correlated with sexual difficulty post-operatively (p=0.022). Subjects with ankylosing spondylitis are having significantly greater sexual difficulty than participants with other diagnosis post-operatively (p<0.001).

None of the subjects have discussed post-total hip arthroplasty sexual life issue with the health care professional. 24 (28.9%) subjects reported their need of more sexual life related information and the most wanted information is safe position for sexual intercourse (75%).

Conclusion

Total hip arthroplasty can significantly improve the quality of sexual life experience of Chinese patients. Further studies are necessary to be done in order to obtain more relevant information and modify the current patient routine assessment and education.