A study presented on March 19 at the 2013 Annual Meeting of the American Academy of Orthopaedic Surgeons found that the sexual functioning of those who had total knee (TKR) or hip (TKH) replacement surgery improved by 90 percent.
There were 174 male and female participants in the study, with a median age of 57.7 years old. Participants filled out questionnaires after receiving TKR or TKH replacement therapy at three different times: before the surgery, six months after the surgery and a full year after the operation.
The study -- the first of its kind, as it asked participants about their well-being prior to the surgery -- found a mix of physical and psychological issues. Prior to knee and hip replacement surgery, 67 percent reported experiencing pain; stiffness (36 percent); reduced libido (49 percent); and an "inability to attain proper position" (14 percent). When it came to their well-being, 91 percent said their arthritis had a negative impact and 53 percent said it hurt their sexual self-image.
But after the surgery, "out of those patients in whom sexual activity was affected before surgery, 81 percent of patients noticed an improvement in the frequency of sexual activity," according to the study. Eighty-four percent said their general well-being improved and 55 percent said their sexual self-esteem improved. Frequency improved for 41 percent of participants, and libido increased for 42 percent. More women (55 percent) than males (34 percent) noticed an improvement in sexual functioning after hip replacement. (Though orgasms didn't seem to be affected either way -- prior to the surgery, 60 percent said arthritis hadn't affected their orgasm occurrence, and 70 percent reported no change in orgasm occurrence after the surgery.)
However not everyone was happy. Sixteen percent of patients felt having the surgery negatively impacted their sex lives, with 4.7 percent saying they weren't able to position themselves correctly; 5.6 percent complaining of pain or discomfort in the affected joint; and 10.1 percent fearing they would potentially damage the replaced the replaced joint (a fear Rodriguez said is unwarranted).
"We posed this question to many ages, from the 20s to the 80s, and the sexual improvement was reported across all ages," said Dr. Jose Rodriguez, an orthopaedic surgeon and director of the Center for Joint Preservation and Reconstruction at Lenox Hill Hospital in New York City. Later quoting one of his patients, he added, "'This is not just about pain, this about my marriage, this is about intimacy, this is about feeling like a person'."
According to the Centers for Disease Control, 27 million Americans live with osteoarthritis. But "people usually wait at least a year or many years because the pain and stiffness doesn't happen immediately," Rodriguez said. "It happens gradually, and they adapt [for awhile] before saying, 'Oh my God, what's happening to me?'
"It's like walking around with a big rock in your shoe," he continued. "Who wants to walk around like that?"
Rodriguez said it's very common to have patients say they didn't realize how much the pain impacted their lives. "Within that morass pain creates, one of them is how sexuality is manifested in their lives," Rodriguez told Huff/Post50. "Many patients have these concerns but very few bring them up with their doctors."
Rodriguez said he believes the study's findings will encourage a more open conversation between arthritis sufferers and their doctors.
"Patients who want to ask there doctor, will [now] ask," he said. "Sometimes patients need a little coaxing to ask questions they have inside them."