Another benefit of hip, knee replacements: Better sex

• Number of hip and knee replacements up
• Average age of patients was 56.8 years old
• Researcher did study because some doctors aren%27t comfortable discussing sex with patients

The rise in hip and knee replacements among Baby Boomers is doing more than putting a fresh spring in their step or helping them stay on the job. It's also making life in the bedroom much better.

Nearly a million people a year have a total hip or knee replacement; numbers have soared in the past 10 years and are expected to keep growing as Boomers refuse to accept the sedentary lifestyle that besets someone with painful arthritis. End-stage arthritis is the leading cause for joint replacement.

In 90% of patients surveyed, total hip or total knee replacement improved overall sexual function, including frequency and duration, according to lead author José A Rodriguez, director of the Center for Joint Preservation and Reconstruction at Lenox Hill Hospital in New York. He will present findings today at the annual meeting of the American Academy of Orthopedic Surgeons in Chicago.

"I never want to see someone's intimacy with a partner destroyed because of a joint problem," Rodriguez says. "Sexual function needs to be discussed with patients when we make routine evaluations. I've found most patients to be very receptive to talking about it."

The average age of patients was 56.8 years old. One limitation of the study is its size: Less than half (147) of 392 patients enrolled in the preoperative study. A total of 116 returned postoperative questionnaires. Patients were asked about their overall well-being and sexual well-being before and after their surgeries.

Rodriguez says he decided to do the study because he knows doctors who aren't comfortable discussing sex with patients.

"I saw a young woman in a wheelchair ask a surgeon for a hip transplant about 18 years ago,'' he says. "She said she wanted to be able to make love with her husband again. The surgeon said no because, in his mind, she was in her 20s, and he didn't want to subject her to revision surgeries.

"Her feeling was, 'My life today is what matters to me.' I understand that completely. That discussion has shaped how I talk with my patients."

Some of the newer implants come with "guarantees'' that they'll last two to three decades. If an implant wears out, a more complicated revision surgery is required. The life of an implant is still unknown, Rodriguez says, but they have greatly improved in two decades.

Nearly twice as many people now get knee replacements (658,340) as hip implants (302,839). Both surgeries have skyrocketed in popularity since 2000, when 282,350 knee replacements and 165,065 hip replacements were done. Other reports to be presented later in the week will look at how quickly people return to work after implants, rather than take disability, and how overall health improves.

"When I started doing total joint replacements two decades ago, people were terrified,'' says orthopedic surgeon John Tongue, outgoing president of the AAOS. "We didn't know how people were going to do with them. Now, it's fascinating. People are scheduling them like they're getting a new carburetor."

How long it takes to heal is always one of the first questions patients ask, Rodriguez says. The postoperative survey was reviewed six months after surgery.

"I tell people the body will let you know when it's time to resume activities,'' he says. "It can be as quickly as six months, but if it hurts, we tell people it's not time yet."