ArticleArchives of orthopaedic and trauma surgery2025
Return to sexual activity after total hip arthroplasty: a comparative study of emergency or elective total hip arthroplasty patients.
Article in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionTo evaluate changes in sexual function and return to sexual activity following total hip arthroplasty (THA), comparing patients who underwent emergency THA for femoral neck fractures with those who underwent elective THA for osteoarthritis, and to identify clinical and demographic predictors of postoperative sexual outcomes.
methodsThis retrospective study included 68 THA patients (37 Emergency THA after Fracture, 31 Elective THA for Osteoarthritis; 54.4% male and 45.6% female). Data included age, sex, BMI, pain during sex, time to resume sex, and postoperative UCLA (University of California-Los Angeles) and FJS-12 (Forgotten Joint Score) scores. Analyses involved t-tests, Chi-square, regression models, and Spearman correlation.
resultsTime to sexual activity resumption did not differ significantly between groups. However, the nature of change varied: patients undergoing elective THA for osteoarthritis more often reported improvement or no change, while patients undergoing emergency THA for femoral neck fractures more commonly reported reduced or ceased activity (p = 0.001). Female sex, older age, and higher BMI were associated with delayed sexual resumption (p < 0.01). Patients who experienced hip pain interfering with sexual activity before surgery were significantly less likely to report improvements in sexual quality after total hip arthroplasty. Although FJS-12 and UCLA scores were strongly correlated (r = 0.869, p < 0.01), they did not independently predict resumption. The multinomial logistic model explained 59.2% of the variance (Nagelkerke R² = 0.592).
conclusionsPost-THA sexual outcomes are influenced by more than physical function. Preoperative pain, age, sex, and psychological readiness are key factors. Comprehensive counseling, especially for patients undergoing emergency THA for femoral neck fractures and for women, should address sexual health expectations during recovery. LEVEL OF EVIDENCE: Level III, retrospective cohort study.
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