TY - JOUR
T1 - Gender-Specific Sexual Activity After Hip Arthroscopy for Femoroacetabular Impingement Syndrome
T2 - Position Matters
AU - Morehouse, Hannah
AU - Sochacki, Kyle R.
AU - Nho, Shane J.
AU - Harris, Joshua D.
N1 - Funding Information:
Conflict of Interest: Hannah Morehouse and Kyle R Sochacki declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Shane J Nho reports research support from Allosource, Arthrex, Athletico, DJO, Linvatec, Miomed, Smith and Nephew, and Stryker; serves as a board or committee member of American Orthopaedic Society for Sports Medicine (AOSSM) and Arthroscopy Association of North America (AANA); is a paid consultant of Stryker and Ossur; and reports IP royalties from Ossur and publishing royalties from Springer. Joshua D. Harris is a board or committee member of American Academy of Orthopaedic Surgeons, AOSSM, AANA, and International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine; is a member of Arthroscopy Editorial Board; reports research support from Smith and Nephew and DePuy, a Johnson & Johnson Company; is a paid consultant of Smith and Nephew, NAC, NIA Magellan, and Ossur); and reports publishing royalties from SLACK, Inc. Funding: None.
Publisher Copyright:
© 2020 International Society for Sexual Medicine
PY - 2020/4
Y1 - 2020/4
N2 - Background: There is limited evidence on the safety of return to sexual activity after hip arthroscopy. Aim: To determine the positional safety of sexual activity after hip arthroscopy relative to hip instability and/or impingement risk. Study Design: This study is an observational study. Methods: 12 common sexual positions were identified based on previous research. Gender-specific hip motion was then assessed for the possibility of postarthroscopic hip instability (due to disruption of iliofemoral ligament [interportal capsulotomy] repair) and/or impingement (labral or capsular compressive stress with disrupted repair) for all 12 positions (both right and left hips; 15 unique male and 14 unique female positions). Instability risk was defined as greater than 0° hip extension, greater than 30° external rotation (ER), or greater than 30° abduction. Impingement risk was defined as greater than 90° hip flexion, greater than 10° internal rotation, and greater than 10° adduction. Outcomes: A majority of both male and female sexual positions caused either instability or impingement, with only 4 positions in women and 4 positions in men deemed “safe” by avoiding excessive hip motion. Results: Return to sexual activity after hip arthroscopy may cause instability in 10/15 of male positions and 5/14 female positions. Most male positions (6/10) were at risk for instability because of excessive ER. 2 positions were unstable because of a combination of ER and extension, one was due to extension, and one abduction. In female instability positions, all 5 were unstable because of excessive abduction. Impingement may be observed in 5 of 15 male positions and 6 of 14 female positions. In male impingement positions, all were due to excessive adduction. 4 female positions risked impingement due to excessive flexion and 2 positions due to internal rotation. Clinical Implications: This study demonstrates risks that should be considered when counseling patients preoperatively and postoperatively regarding sexual activity. Strengths & Limitations: This study closely models a hip preservation patient population by using 2 young and otherwise healthy individuals. The most significant limitation of this investigation was its basis with only 2 young healthy volunteers (one male, one female) in a single motion capture session using surface-based spherical retroreflective markers from a previous investigation. Conclusion: After hip arthroscopy, patients need to be made aware of the possibility of hip instability (10 of 15 men; 5 of 14 women) and impingement (5 of 15 men; 6 of 14 women) due to excessive hip motion that may compromise their outcome. Morehouse H, Sochacki KR, Nho SJ, et al. Gender-Specific Sexual Activity After Hip Arthroscopy for Femoroacetabular Impingement Syndrome: Position Matters. J Sex Med 2020;17:658–664.
AB - Background: There is limited evidence on the safety of return to sexual activity after hip arthroscopy. Aim: To determine the positional safety of sexual activity after hip arthroscopy relative to hip instability and/or impingement risk. Study Design: This study is an observational study. Methods: 12 common sexual positions were identified based on previous research. Gender-specific hip motion was then assessed for the possibility of postarthroscopic hip instability (due to disruption of iliofemoral ligament [interportal capsulotomy] repair) and/or impingement (labral or capsular compressive stress with disrupted repair) for all 12 positions (both right and left hips; 15 unique male and 14 unique female positions). Instability risk was defined as greater than 0° hip extension, greater than 30° external rotation (ER), or greater than 30° abduction. Impingement risk was defined as greater than 90° hip flexion, greater than 10° internal rotation, and greater than 10° adduction. Outcomes: A majority of both male and female sexual positions caused either instability or impingement, with only 4 positions in women and 4 positions in men deemed “safe” by avoiding excessive hip motion. Results: Return to sexual activity after hip arthroscopy may cause instability in 10/15 of male positions and 5/14 female positions. Most male positions (6/10) were at risk for instability because of excessive ER. 2 positions were unstable because of a combination of ER and extension, one was due to extension, and one abduction. In female instability positions, all 5 were unstable because of excessive abduction. Impingement may be observed in 5 of 15 male positions and 6 of 14 female positions. In male impingement positions, all were due to excessive adduction. 4 female positions risked impingement due to excessive flexion and 2 positions due to internal rotation. Clinical Implications: This study demonstrates risks that should be considered when counseling patients preoperatively and postoperatively regarding sexual activity. Strengths & Limitations: This study closely models a hip preservation patient population by using 2 young and otherwise healthy individuals. The most significant limitation of this investigation was its basis with only 2 young healthy volunteers (one male, one female) in a single motion capture session using surface-based spherical retroreflective markers from a previous investigation. Conclusion: After hip arthroscopy, patients need to be made aware of the possibility of hip instability (10 of 15 men; 5 of 14 women) and impingement (5 of 15 men; 6 of 14 women) due to excessive hip motion that may compromise their outcome. Morehouse H, Sochacki KR, Nho SJ, et al. Gender-Specific Sexual Activity After Hip Arthroscopy for Femoroacetabular Impingement Syndrome: Position Matters. J Sex Med 2020;17:658–664.
KW - Femoroacetabular Impingement
KW - Hip Arthroscopy
KW - Instability
KW - Sexual Positions
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U2 - 10.1016/j.jsxm.2019.12.026
DO - 10.1016/j.jsxm.2019.12.026
M3 - Article
C2 - 32046945
AN - SCOPUS:85079137356
VL - 17
SP - 658
EP - 664
JO - Journal of Sexual Medicine
JF - Journal of Sexual Medicine
SN - 1743-6095
IS - 4
ER -