Abstract
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.
Original language | English (US) |
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Pages (from-to) | 658-664 |
Number of pages | 7 |
Journal | Journal of Sexual Medicine |
Volume | 17 |
Issue number | 4 |
DOIs | |
State | Published - Apr 2020 |
Keywords
- Femoroacetabular Impingement
- Hip Arthroscopy
- Instability
- Sexual Positions
- Femoracetabular Impingement/surgery
- Humans
- Hip Joint/surgery
- Sexual Behavior/physiology
- Male
- Rotation
- Arthroscopy
- Range of Motion, Articular
- Adult
- Female
ASJC Scopus subject areas
- Psychiatry and Mental health
- Urology
- Endocrinology
- Obstetrics and Gynecology
- Endocrinology, Diabetes and Metabolism
- Reproductive Medicine