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关节炎行全髋关节和全膝关节置换术后性功能的改善。

Improved Sexual Function After Total Hip and Knee Arthroplasty for Osteoarthritis.

出版信息

Orthopedics. 2021 Mar-Apr;44(2):111-116. doi: 10.3928/01477447-20210104-01. Epub 2021 Jan 8.

DOI:10.3928/01477447-20210104-01
PMID:33416895
Abstract

Osteoarthritis of the hip and knee is known to affect sexual activity. For patients with osteoarthritis, pain during sexual activity can lead to decreased quality of life and other associated health issues. The authors designed a prospective study to evaluate the effect of total hip arthroplasty and total knee arthroplasty on the psychosocial and physical aspects of sexuality pre- and postoperatively. Between April 2009 and December 2011, patients received questionnaires in the mail preoperatively. They were asked to return the preoperative questionnaire before surgery and the postoperative questionnaire 6 months after surgery. Data were analyzed to evaluate the psychosocial and physical aspects of sexuality and participants' subjective assessment of their appearance. Preoperatively, 91% and 67% of patients reported psychosocial and physical issues, respectively. After the arthroplasty procedure, 84% (<.001) and 47% (<.001) of patients reported improvement psychosocially and physically, respectively. Of the patients, 16% reported that arthroplasty adversely affected sexual function, with their predominant fear being joint damage (63%). A greater number of women and patients undergoing hip procedures reported improvement in sexual activity after surgery compared with men (=.02) and patients undergoing knee procedures (=.002). Both hip and knee osteoarthritis and arthroplasty had a significant effect on overall sexual function-psychosocially, physically, and in terms of patients' assessment of their external appearance-with higher rates of improvement seen after hip arthroplasty. Because of the effect of osteoarthritis and arthroplasty on sexual function, this topic should be addressed both pre- and postoperatively. [. 2021;44(2):111-116.].

摘要

髋膝关节骨关节炎已知会影响性行为。对于骨关节炎患者,活动时的疼痛可导致生活质量下降和其他相关健康问题。作者设计了一项前瞻性研究,以评估全髋关节置换术和全膝关节置换术对术前和术后性功能的心理社会和身体方面的影响。在 2009 年 4 月至 2011 年 12 月期间,患者在术前通过邮件收到问卷。要求他们在手术前返回术前问卷,并在手术后 6 个月后返回术后问卷。对数据进行分析以评估性功能的心理社会和身体方面以及参与者对自身外表的主观评估。术前,分别有 91%和 67%的患者报告存在心理社会和身体问题。在关节置换手术后,分别有 84%(<.001)和 47%(<.001)的患者在心理社会和身体方面报告有所改善。有 16%的患者报告关节置换术对性功能产生了不利影响,他们的主要担忧是关节损伤(63%)。与男性(=.02)和膝关节手术患者(=.002)相比,更多的女性和接受髋关节手术的患者报告术后性功能有所改善。髋关节和膝关节骨关节炎和关节置换术对整体性功能(心理社会、身体方面以及患者对自身外表的评估)均有显著影响,髋关节置换术后改善率更高。由于骨关节炎和关节置换术对性功能的影响,这个问题应该在术前和术后都要解决。[. 2021;44(2):111-116.].

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