Replacement of knee replacement does not solve sexual problems

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(Reuters Health) – Sometimes patients with knee replacement surgery hope to get their sexual activity back or improve later, but that does not always happen, a new study gets out.

One year after surgery, about 40% of patients said their expectations of sexual activity were not expected, researchers report in Clinical Orthopedics and Related Research.

“Patients usually have high expectations of prosthesis results and expect to be active despite their age, including sexual activity,” said Rita Harmsen, head of study at the Leiden University Medical Center in the Netherlands. .

“Sexual activity is important for the quality of life for both men and women, but sexual issues cannot be easily discussed – not in everyday 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 restart safely) are missing, and surgeons are not aware of hidden issues.”

Harmsen and his colleagues analyzed data for over 800 patients scheduled for a full knee replacement in 2012-2015 at seven hospitals in the Netherlands. Patients rated their pre-operational expectations and post-operative performance on a 5 point scale.

Prior to knee replacement surgery, about half of patients were expecting better sexual activity after their recovery. Men were more likely to have expectations of post-operative sexual activity, particularly men under 60 years of age. Approximately 46% of men were expecting “sexual activity”, compared to 32% of women. In relation to both genders, the prediction of age decreased.

Overall, approximately 58% reported that their expectations were met following surgery, which was almost equal to men and women. Compliance was slightly lower in age groups higher for both genders. Women were under 65 years of age more often than men of the same age.

More importantly, people with better health before surgery are more likely to report better sexual activity after surgery. And patients with more health improvements after surgery reported having met or exceeded sexual expectations.

“At the same time, around 40%, or two in five patients, had unfilled expectations,” said Harmsen. “These results are disappointing.”

The limitation of the study is that all pre-operative expectations and post-operative compliance were measured with one survey question, the authors of the study wrote. Future studies should interview patients and their partners to find out what the expectations are and why they are not happy after an operation, Harmsen said. There may be difficulties with age, inadequate rehabilitation, or post-operative knee mobility, which can limit certain sexual settings. Patients may need education about comfortable and safe sexual settings after knee replacement, she said.

“As surgeons, this aspect is often not enough to be addressed, and it is important to set realistic expectations after surgery,” said Dr. Antonia Chen from Brigham and Women's Hospital in Boston, Massachusetts. Chen, not involved in this study, is the research director of arthritis services.

In addition, longer studies could indicate whether it takes more than a year after surgery for patients to return to normal sexual activity levels or to meet their expectations, she said.

“Patients who replace complete knee replacement after surgery have improved overall physical function,” she told Reuters Health by email. “However, it is worth discussing before surgery with your surgeon about the expectations of sexual activity so that you can better understand the likelihood of your expectations being fulfilled or that there may be exciting expectations. after surgery. ”

SOURCE: bit.ly/2qrBwqI Clinical Orthopedics and Related Research, online November 1, 2019.

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. t) Arthritis (t) Sexual Health (t) Clinical Medicine (t) Healthcare (TRBC)

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