{"title":"Return to sexual activity after total hip arthroplasty: a comparative study of emergency or elective total hip arthroplasty patients","authors":"Sule Atalay Mert, Ali Can Çiçek","doi":"10.1007/s00402-025-06083-5","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>To 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.</p><h3>Methods</h3><p>This 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.</p><h3>Results</h3><p>Time 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 (<i>p</i> = 0.001). Female sex, older age, and higher BMI were associated with delayed sexual resumption (<i>p</i> < 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 (<i>r</i> = 0.869, <i>p</i> < 0.01), they did not independently predict resumption. The multinomial logistic model explained 59.2% of the variance (Nagelkerke R² = 0.592).</p><h3>Conclusions</h3><p>Post-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.</p><h3>Level of evidence</h3><p>Level III, retrospective cohort study.</p></div>","PeriodicalId":8326,"journal":{"name":"Archives of Orthopaedic and Trauma Surgery","volume":"145 1","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Orthopaedic and Trauma Surgery","FirstCategoryId":"3","ListUrlMain":"https://link.springer.com/article/10.1007/s00402-025-06083-5","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
To 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.
Methods
This 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.
Results
Time 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).
Conclusions
Post-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.
期刊介绍：
"Archives of Orthopaedic and Trauma Surgery" is a rich source of instruction and information for physicians in clinical practice and research in the extensive field of orthopaedics and traumatology. The journal publishes papers that deal with diseases and injuries of the musculoskeletal system from all fields and aspects of medicine. The journal is particularly interested in papers that satisfy the information needs of orthopaedic clinicians and practitioners. The journal places special emphasis on clinical relevance.
"Archives of Orthopaedic and Trauma Surgery" is the official journal of the German Speaking Arthroscopy Association (AGA).
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