Osteoarthritis of the hip or knee, affecting millions of Americans each year, is known to limit sexual activity. New research presented today at the 2013 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) found that total hip (THR) or total knee replacement (TKR) surgery improves sexual function in 90 percent of patients.

In the study, 147 patients under age 70, scheduled for primary THR or TKR, agreed to participate in a study requiring the completion of questionnaires prior to surgery, at six months post surgery, and at one year post surgery. Sixty-five percent of patients returned all three surveys.

The group of patients included 68 men and 78 women with a mean age of 57.7 years. Among the results:

    Sixty-seven percent of the patients reported physical problems with sexual activity prior to surgery -- 67 percent pain; 36 percent, stiffness; 49 percent, reduced libido; and 14 percent, inability to attain proper position.
    Ninety-one percent of participating patients reported psychological issues related to their osteoarthritis -- 91 percent diminished general well being, and 53 percent, diminished sexual self image.

Following the surgery, 42 percent of patients reported an improvement in libido; 41 percent, increased intercourse duration; and 41 percent, increased intercourse frequency. Eighty-four percent of patients reported improvement in their general well being, and 55 percent in their sexual self image. Sixteen percent of patients reported that their joint replacement surgery adversely affected their sexual function, primarily due to a fear of damaging the replaced joint.

Overall, 90 percent of THR and TKR patients reported improved overall sexual function, with a slightly higher rate of improvement after THR than TKR. More females reported improvement after THR than males.

"This study emphasizes the importance of including sexuality and sexual activity as an important component of evaluating the functional outcome of total hip and total knee (replacement)," said principal investigator Jose A Rodriguez MD, orthopaedic surgeon and chief, Center for Joint Preservation and Reconstruction at Lenox Hill Hospital in New York.

Hip or knee replacement does "offer improvement in sexual activity and overall sexuality to patients after surgery, especially if (sexuality) is affected before surgery," said Dr. Rodriguez.

As some patients reported a fear of damaging their new hip or knee as a reason to limit sexual activity following surgery, "it is important for the health care provider to discuss the functional status of each patient in terms of sexual activity and overall sexuality," said Dr. Rodriguez. "This could be in the form of a one-on-one discussion with patients, or (the provision) of information booklets, or both if necessary, to effectively determine and address this fear."