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Patient Expectations of Sexual Activity After Total Hip Arthroplasty: A Prospective Multicenter Cohort Study

BACKGROUND: This study aimed to evaluate patients’ expectations of postoperative sexual activity (SA) after total hip arthroplasty. METHODS: A prospective multicenter cohort study of 1,271 patients managed with total hip arthroplasty was performed using patient-reported outcome measures of the Longi...

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Autores principales: Harmsen, Rita T.E., den Oudsten, Brenda L., Putter, Hein, Leichtenberg, Claudia S., Elzevier, Henk W., Nelissen, Rob G.H.H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6400513/
https://www.ncbi.nlm.nih.gov/pubmed/30882057
http://dx.doi.org/10.2106/JBJS.OA.18.00031
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author Harmsen, Rita T.E.
den Oudsten, Brenda L.
Putter, Hein
Leichtenberg, Claudia S.
Elzevier, Henk W.
Nelissen, Rob G.H.H.
author_facet Harmsen, Rita T.E.
den Oudsten, Brenda L.
Putter, Hein
Leichtenberg, Claudia S.
Elzevier, Henk W.
Nelissen, Rob G.H.H.
author_sort Harmsen, Rita T.E.
collection PubMed
description BACKGROUND: This study aimed to evaluate patients’ expectations of postoperative sexual activity (SA) after total hip arthroplasty. METHODS: A prospective multicenter cohort study of 1,271 patients managed with total hip arthroplasty was performed using patient-reported outcome measures of the Longitudinal Leiden Orthopaedics Outcomes of Osteo-Arthritis Study (LOAS). Preoperative SA expectations and their fulfillment after 1 year were assessed with the Hospital for Special Surgery expectations survey. The Hip disability and Osteoarthritis Outcome Score (HOOS) was used to measure functional status, and the Short Form-12 Mental and Physical Component Summary scores (SF-12 MCS and SF-12 PCS) and EuroQol-5 Dimensions (EQ-5D) questionnaire were used to measure health status. Two subgroups were defined preoperatively: the SA-Expecting Group and the No-SA-Expecting Group. The postoperative outcomes with regard to SA (i.e., the difference between postoperative and preoperative SA scores) were classified as “unfulfilled” (score, ≤−1), “fulfilled” (score, 0), or “exceeded” (score, ≥1). Multivariate regression analyses were used, with t tests to compare means between groups. RESULTS: In total, 952 (74.9%) patients returned both preoperative and postoperative HSS questionnaires. Preoperatively, 605 patients (63.6%) expected to have postoperative SA. At 1 year, 43.5% of participants reported that this expectation was unfulfilled. In the No-SA-Expecting Group, 18.2% (63 of 347) regained SA, predominantly men. Postoperative SA fulfillment was related to preoperative musculoskeletal (p = 0.001) and non-musculoskeletal comorbidities (p = 0.004) and the postoperative HOOS, SF-12 PCS, SF-12 MCS, EQ-5D, and EQ-5D visual analog scale (VAS) scores (p < 0.001). Postoperative HOOS-symptoms (odds ratio [OR] 1.04; 95% confidence interval [CI], 1.02 to 1.06; p < 0.001), and HOOS-sport (OR, 1.01; 95% CI, 1.00 to 1.03; p = 0.032) were associated with postoperative SA fulfillment, as was older age (inversely; e.g., ≥76 years compared with ≤60 years: OR, 0.28; 95% CI, 0.13 to 0.62; p = 0.002). Correspondingly, for the No-SA-Expecting Group, higher age was also inversely associated with regaining postoperative SA (e.g., ≥76 years: OR, 0.07; 95% CI, 0.02 to 0.21; p < 0.001). CONCLUSIONS: Of the patients who expected to be sexually active after surgery, 43.5% perceived this expectation to be unfulfilled; 24.3% were still sexually inactive despite most having expected a return to normal SA. Approximately one-fifth of patients who did not expect postoperative SA in fact regained SA. During preoperative consultations, surgeons should pay attention to expectation management surrounding SA. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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spelling pubmed-64005132019-03-16 Patient Expectations of Sexual Activity After Total Hip Arthroplasty: A Prospective Multicenter Cohort Study Harmsen, Rita T.E. den Oudsten, Brenda L. Putter, Hein Leichtenberg, Claudia S. Elzevier, Henk W. Nelissen, Rob G.H.H. JB JS Open Access Scientific Articles BACKGROUND: This study aimed to evaluate patients’ expectations of postoperative sexual activity (SA) after total hip arthroplasty. METHODS: A prospective multicenter cohort study of 1,271 patients managed with total hip arthroplasty was performed using patient-reported outcome measures of the Longitudinal Leiden Orthopaedics Outcomes of Osteo-Arthritis Study (LOAS). Preoperative SA expectations and their fulfillment after 1 year were assessed with the Hospital for Special Surgery expectations survey. The Hip disability and Osteoarthritis Outcome Score (HOOS) was used to measure functional status, and the Short Form-12 Mental and Physical Component Summary scores (SF-12 MCS and SF-12 PCS) and EuroQol-5 Dimensions (EQ-5D) questionnaire were used to measure health status. Two subgroups were defined preoperatively: the SA-Expecting Group and the No-SA-Expecting Group. The postoperative outcomes with regard to SA (i.e., the difference between postoperative and preoperative SA scores) were classified as “unfulfilled” (score, ≤−1), “fulfilled” (score, 0), or “exceeded” (score, ≥1). Multivariate regression analyses were used, with t tests to compare means between groups. RESULTS: In total, 952 (74.9%) patients returned both preoperative and postoperative HSS questionnaires. Preoperatively, 605 patients (63.6%) expected to have postoperative SA. At 1 year, 43.5% of participants reported that this expectation was unfulfilled. In the No-SA-Expecting Group, 18.2% (63 of 347) regained SA, predominantly men. Postoperative SA fulfillment was related to preoperative musculoskeletal (p = 0.001) and non-musculoskeletal comorbidities (p = 0.004) and the postoperative HOOS, SF-12 PCS, SF-12 MCS, EQ-5D, and EQ-5D visual analog scale (VAS) scores (p < 0.001). Postoperative HOOS-symptoms (odds ratio [OR] 1.04; 95% confidence interval [CI], 1.02 to 1.06; p < 0.001), and HOOS-sport (OR, 1.01; 95% CI, 1.00 to 1.03; p = 0.032) were associated with postoperative SA fulfillment, as was older age (inversely; e.g., ≥76 years compared with ≤60 years: OR, 0.28; 95% CI, 0.13 to 0.62; p = 0.002). Correspondingly, for the No-SA-Expecting Group, higher age was also inversely associated with regaining postoperative SA (e.g., ≥76 years: OR, 0.07; 95% CI, 0.02 to 0.21; p < 0.001). CONCLUSIONS: Of the patients who expected to be sexually active after surgery, 43.5% perceived this expectation to be unfulfilled; 24.3% were still sexually inactive despite most having expected a return to normal SA. Approximately one-fifth of patients who did not expect postoperative SA in fact regained SA. During preoperative consultations, surgeons should pay attention to expectation management surrounding SA. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. Wolters Kluwer 2018-10-04 /pmc/articles/PMC6400513/ /pubmed/30882057 http://dx.doi.org/10.2106/JBJS.OA.18.00031 Text en Copyright © 2018 The Authors. Published by The Journal of Bone and Joint Surgery, Incorporated. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/) (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Scientific Articles
Harmsen, Rita T.E.
den Oudsten, Brenda L.
Putter, Hein
Leichtenberg, Claudia S.
Elzevier, Henk W.
Nelissen, Rob G.H.H.
Patient Expectations of Sexual Activity After Total Hip Arthroplasty: A Prospective Multicenter Cohort Study
title Patient Expectations of Sexual Activity After Total Hip Arthroplasty: A Prospective Multicenter Cohort Study
title_full Patient Expectations of Sexual Activity After Total Hip Arthroplasty: A Prospective Multicenter Cohort Study
title_fullStr Patient Expectations of Sexual Activity After Total Hip Arthroplasty: A Prospective Multicenter Cohort Study
title_full_unstemmed Patient Expectations of Sexual Activity After Total Hip Arthroplasty: A Prospective Multicenter Cohort Study
title_short Patient Expectations of Sexual Activity After Total Hip Arthroplasty: A Prospective Multicenter Cohort Study
title_sort patient expectations of sexual activity after total hip arthroplasty: a prospective multicenter cohort study
topic Scientific Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6400513/
https://www.ncbi.nlm.nih.gov/pubmed/30882057
http://dx.doi.org/10.2106/JBJS.OA.18.00031
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