Sex After Joint Replacement Surgery

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We often talk about reasons to have joint replacement surgery. Common reasons to have knee or hip replacement include difficulty walking, exercising, or sleeping. Pain may interfere with activity, and restricted mobility may limit what you can do. But we don't often talk about sex. And the truth is, severe hip arthritis and knee arthritis can have a significant effect on sex life and may limit people's sexual happiness.

Arthritis and Sex

To answer the question about how much arthritis impacts sex life, researchers asked 147 patients who were scheduled to have a knee replacement or hip replacement surgery about their sex life. The study, presented at the 2013 American Academy of Orthopaedic Surgeons annual meeting in Chicago, asked patients before and after their surgery about their sex life, and came up with the following findings:

  • 2/3 of patients have significant problems with sex before surgery because of their arthritic joint. The most common problems were joint pain, lack of mobility, and loss of libido.
  • 90% of patients reported psychological issues related to their joint problem, including over 50% who had a poor sexual self-image.

Effects of Joint Replacement on Sex Life

  • Over 90% of patients reported an improvement in their sexual function after joint replacement surgery, including significant improvements in libido as well as improved duration and frequency of intercourse.
  • Only 16% of patients reported adverse effects to sexual well-being, with most being concerns about the potential for damaging their implanted joint while having sex.

Concerns About Sex After Joint Replacement

Most patient concerns about sex after joint replacement are related to possible damage to the newly implanted joint. In general, joint replacements last longest when they are not subjected to excessive forces. This means that patients with joint replacements may be told to avoid some sports activities and to keep their weight down to prevent excess pressure on the implant. It is reasonable to question the effect of sex on the joint.

The other major concern is specific to hip replacement surgery, and that is the possibility of sustaining a dislocation of the hip replacement implant. A hip replacement dislocation is an unusual complication but does occur in about 4% of patients who have this surgery. Because of the concern for possible dislocation, there are post-surgical precautions many surgeons recommend for patients who have had hip replacement surgery.

I would recommend you discuss concerns you might have about hip dislocation as there are special types of implants that may have a lower chance of dislocation and there are ways of performing a hip replacement, such as anterior approach hip replacement, that may lower the chance for this complication.

In order to prevent problems with your new joint, there are some general recommendations about enjoying sex in a way that is safe for your joint replacement:

  • Avoid excessive pressure directly on the implant
  • Avoid kneeling on a replaced knee
  • Do not support your partner on a replaced joint
  • Check with your doctor before resuming sex after surgery

Sex and Joint Replacements

It's something few patients bring up in discussions with their doctor, but it's not something you should be afraid of discussing. Sexual well-being is important in our lives, and one of the ways to improve sexual health may be joint replacement surgery.

Researchers pointed out the significant improvement in many aspects of sexual health and happiness. Interestingly, they detected the most dramatic improvement in women with hip arthritis, who had significant improvements in the ability to enjoy intercourse again.

If sexual happiness is being impaired by your bad hip or knee, it may be worthwhile to discuss this with your surgeon. While there are many reasons to have a joint replacement, it is important that all of the important factors be recognized.

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