Changes in sexual health following total hip arthroplasty in heterosexual patients with stiff hips and their partners: a retrospective study

Xiaojin Wu^1,2Shiyong Wang¹Ru-dong Chen¹Haitao Hu¹Ma Rong^1,3Yanbin Tian^2*Zhaohui Ge^3*

• ¹The First Clinical Medical College, Ningxia Medical University, Yinchuan, China
• ²Yinchuan Guolong Orthopedic Hospital, Yinchuan, China
• ³General Hospital of Ningxia Medical University, Yinchuan, China

Background: Sexual activity is an integral component of a healthy life. However, research on changes in sexual activity among patients with stiff hips and their partners before and after total hip arthroplasty (THA) remains limited. This study aims to investigate alterations in sexual activity following THA in heterosexual patients and their partners, and to assess its impact on sexual satisfaction, quality of life, and dyadic relationships. Methods: An anonymous, specifically designed sexual health survey was distributed to 65 patients undergoing THA for stiff or fused hips and their partners. This survey assessed changes in sexual satisfaction and activity, quality of life (QoL), and influencing factors from both patient and partner perspectives pre-and post-operatively. It also evaluated perioperative sexual health counseling received by patients. Each questionnaire item was analyzed independently using statistical software. Results: 48 patients provided analyzable data at study completion. Significant improvements (p<0.001) were observed in VAS scores, Harris Scores, and hip range of motion (ROM) at final follow-up. The mean time to resume sexual activity post-THA was 3.6 ± 1.4 months (male 2.9 ± 1.2 vs female 4.5 ± 1.1). By final follow-up, QoL and dyadic relationships showed marked improvement. Sexual frequency increased in 93.7% of patients, 60.4% adopted varied coital positions, and mean sexual satisfaction rose from 24% preoperatively to 82% postoperatively (p<0.001). The primary factors limiting preoperative and postoperative sexual activity were restricted hip mobility, pain, and fear of prosthesis damage. No patients received perioperative sexual health counseling, yet 85.4% desired professional rehabilitation guidance, and 25% requested communication strategies with partners and pain management techniques. Regarding surgical decision-making, 60.4% would consider THA if hip pathology solely impaired sexual health. Partners reported significant improvements in patients' QoL and sexual health postoperatively. Although partners expressed concerns about causing physical discomfort, all were willing to make adaptive adjustments. Conclusion: Stiff hips significantly impact patients' sexual health. THA demonstrates positive effects on sexual activity, QoL, and dyadic relationships for both patients and their partners. It is therefore essential to enhance healthcare providers' awareness of patients' sexual needs and provide individualized perioperative sexual counseling.