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Comparing Outcomes in Sexual Function After Total Hip and Knee Arthroplasty: A Systematic Review
S Y Pendyala1, N Akram1, V Asopa1
1Research Department of South West London Elective Orthopaedic Centre (SWLEOC), Surrey, United Kingdom.
The Journal of Arthroplasty
|January 14, 2026
Summary
Sexual function improves after hip or knee replacement surgery. Patients with knee replacements return to sexual activity sooner, while hip replacement patients report greater sexual satisfaction and frequency.
Area of Science:
- Orthopedic Surgery
- Sexual Health
- Quality of Life Research
Background:
- Sexual function is vital for quality of life but often overlooked in lower-limb arthroplasty care and research.
- Existing evidence on sexual outcomes post-arthroplasty is fragmented across hip and knee procedures.
- A direct comparison of sexual function recovery between total hip arthroplasty (THA) and total knee arthroplasty (TKA) is lacking.
Purpose of the Study:
- To compare sexual outcomes after total hip arthroplasty (THA) versus total knee arthroplasty (TKA).
- To analyze differences in return to sexual activity (RTSA), frequency of sexual activity (FSA), and sexual satisfaction (SS).
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Searched major biomedical databases and trial registries for studies on sexual function post-THA or TKA.
- Included 27 studies with 9,267 patients; two reviewers screened, extracted data, and assessed bias.
Main Results:
- Return to sexual activity (RTSA) was generally quicker after TKA than THA.
- A higher proportion of THA patients reported greater sexual satisfaction (SS) (75.4%) compared to TKA patients (69.3%).
- THA patients showed significantly greater increases in the frequency of sexual activity (FSA).
Conclusions:
- Arthroplasty enhances sexual function, with distinct recovery trajectories for hip and knee replacements.
- TKA facilitates an earlier return to sexual activity, whereas THA leads to greater improvements in sexual frequency and satisfaction.
- Standardized instruments and high-quality prospective studies are needed to advance understanding and improve patient counseling.
