Assessing Sexual and Functional Outcomes After Direct Anterior Approach Total Hip Arthroplasty: Insights from a Retrospective Study.

Purpose of the study: The direct anterior approach (DAA) is favored for its muscle-sparing benefits and rapid recovery after total hip arthroplasty (THA). While functional outcomes are well-documented, the impact of DAA THA on sexual health remains underexplored. This study evaluates the resumption of sexual activity and functional recovery in male patients following DAA THA.

Methods: A retrospective review of male patients who underwent DAA THA (January 2023 and December 2023) was assessed pre- and post-operatively (2 weeks, 12 weeks, and 1-year) for sexual function using the Sexual Health Inventory for Men (SHIM) and hip functionality through the Harris Hip Score (HHS). Statistical significance was set at p < 0.05.

Results: Among 64 patients (mean age: 31.4 ± 4.9 years), 73.5% resumed sexual activity within 2 weeks, rising to 95% by 12 weeks. Of those sexually active within 2 weeks, 93% reported a SHIM score of ≥ 20. By 1 year, all patients resumed sexual activity with a mean SHIM score of 23.5. Functional recovery showed a significant improvement in HHS from 39.3 ± 1.4 pre-operatively to 98.9 ± 0.9 at 1 year (p < 0.05). Minor complications, including superficial wound dehiscence (n = 2), were conservatively managed, with no dislocations or major complications reported.

Conclusion: DAA THA improves hip function and early resumption to sexual activity, an essential yet overlooked aspect in younger male patients. With 95% resuming sexual activity within 12 weeks and full functional restoration by 1 year, DAA THA proves as a safe and effective approach, making it an ideal choice for active, young individuals seeking physical and personal well-being after surgery.