Talking about sex isn’t easy for many doctors and their patients. Hip arthritis makes sex painful for men and women, and there’s lots of evidence that sexual problems make people very unhappy. Many patients who have had a hip replacement are concerned that having sex will damage their new hip, or cause it to dislocate, and they are often embarrassed about talking to their surgeons about it.

A few years ago, we decided to study the effects of hip arthritis and hip replacements on sexual function so that we could provide patients with evidence based advice on what to expect after surgery. The results have been amazing!

Together with my colleague Simon Tilley and gynaecologist Ash Monga, we developed an outcome measure to allow us to compare sexual function before and after surgery. Our study population was sexually active women under the age of 65. Simon was in Sydney doing a Fellowship in joint replacement surgery, and he did a pilot study there. He found that 37% of women would have had a hip replacement solely to make sex less painful. Patients reported significant improvements both in their ability to have sex in their preferred positions and their levels of satisfaction within their relationships. Nearly all of the patients wished that they could have had more information about how their condition and treatment would affect sexual function.

As a specialist hip surgeon, I use different materials and devices to tailor the surgery to the patient’s anatomy, pathology and expectations. For example, in my younger female patients I tend to use ceramic bearings, whereas in men I will use a hip resurfacing. The results of our work will be used to see if this type of bespoke approach to hip replacements surgery will improve outcomes for patients in all aspects of their lives.

We are recruiting patients for the UK study both at the Spire Southampton Hospital and Southampton General Hospital. We are also working on developing the study to include patients with knee problems, and to look at how patients’ partners are affected by their conditions and treatment. We will publish a handbook for patients and healthcare professionals which will provide up to date evidence-based advice for all concerned.

The potential to apply this approach to other health problems such as cancer, heart disease, obesity and plastic surgery is limitless. Our pioneering work has attracted a great deal of interest around the world, and has lead to the development of an exciting collaboration with experts in the management of sexual dysfunction. A new clinical service at the Spire Southampton Hospital using a psychotherapeutic approach will be offered to patients in the very near future.

If you would like to discuss any aspects of this work, please get in touch.