Knee replacement doesn’t solve sexual problems

(Reuters Health) – Patients having knee replacement surgery sometimes hope to regain or improve their sexual activity afterward, but that doesn't always happen, a new study finds.

A year after surgery, about 40per cent of patients said their expectations of sexual activity weren't met, researchers report in Clinical Orthopaedics and Related Research.

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"Patients generally have high expectations towards the results of a prosthesis and expect to remain active despite their age, which also includes sexual activity," said study leader Rita Harmsen of Leiden University Medical Center in the Netherlands.

"Sexual activity is important to quality of life for men and women alike, however, sexual issues are not easily discussed – not in daily life, not in the consultation room, not by specialists, not by patients," she told Reuters Health by email. "After surgery, effective instructions (about how to safely resume) are missing, and surgeons are not aware of hidden questions."

Harmsen and colleagues analyzed data for more than 800 patients scheduled for total knee replacement in 2012-2015 at seven hospitals in The Netherlands. Patients ranked their preoperative expectations and postoperative fulfillment on a 5-point scale.

Before the knee replacement surgery, about half of patients expected better sexual activity after recovery. Men were more likely to have expectations for postoperative sexual activity, particularly men under age 60. About 46per cent of men expected "back to normal" sexual activity, compared with 32per cent of women. For both genders, anticipation decreased with age.

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Overall, about 58per cent reported fulfillment of their expectations after surgery, which was nearly equal for men and women. Fulfilment was slightly lower in higher age groups for both genders. Women under age 65 experienced fulfillment more often than men of the same age.

Importantly, those in better health before surgery were more likely to report better sexual activity after surgery. And patients who experienced greater health improvements after surgery reported fulfilled or exceeded sexual expectations as well.

"At the same time, about 40per cent, or two out of five patients, experienced unfilled expectations," Harmsen said. "These results can be very disappointing."

A limitation of the study is that preoperative expectations and postoperative fulfillment were each measured with just one survey question, the study authors wrote. Future studies should interview patients and their partners to understand what the expectations were and why they're unfulfilled after surgery, Harmsen said. Difficulties may be related to age, insufficient rehabilitation, or the mobility of the knee after surgery, which can limit certain sexual positions. Patients may need education Read More – Source