Patients experience mixed results with respect to sexual quality and frequency after total knee arthroplasty: a systematic review

Kazarian, Gregory S.; Chen, Antonia F.

doi:10.1136/jisakos-2016-000084

Cited by 4 publications

(7 citation statements)

References 59 publications

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“…A less commonly reported theme was sexual function, which is underreported in the literature with respect to TKR [ 31 ]. Sexual function is not captured in commonly used PROMs such as the Oxford Knee Score, Forgotten Joint Score and Knee Society Score [ 4 , 15 , 47 ].…”

Section: Discussionmentioning

confidence: 99%

What’s important for recovery after a total knee replacement? A systematic review of mixed methods studies

Khatri,

Ahmed,

Dhaif

et al. 2023

Arch Orthop Trauma Surg

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Background Understanding how patients perceive and prioritise various aspects of recovery following total knee replacement, including pain, function and return to activity, will help clinicians in pre-operative consultations by ensuring they effectively address patient concerns and managing their expectations. Aims The aim of this study is to identify aspects of recovery that are important to people after a total knee replacement. Methods Studies were identified from Medline, Embase, PsycInfo, Cochrane Library and Web of Science. This mixed methods review included all original study types (quantitative, qualitative, discrete choice experiments and mixed methods design). Reviews and non-peer-reviewed publications were excluded. Studies with participants (age ≥ 18 years) who had a primary TKR for osteoarthritis were included. Studies of people with unicompartmental knee, patella-femoral or revision knee replacement were excluded. Recovery attributes were extracted from individual papers and grouped into recovery themes. Results A total of 23 studies with 8404 participants and 18 recovery themes were developed. The most frequently identified overarching theme was pain, followed by activities of daily living, mobility (walking), recreational activities, specific functional movements of the knee, use of walking aids, sexual activity and range of motion of the knee. Medical complications were an infrequently reported theme, however, was deemed to be high importance. Conclusions Reducing pain, returning of activities and daily living and mobility are the three most frequently reported recovery domains for people after TKR. Clinicians should be aware of recovery themes, to ensure they are explored sufficiently when consenting for a TKR. Future research should aim to determine the relative importance of these attributes compared to each other. Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021253699

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Section: Discussionmentioning

confidence: 99%

What’s important for recovery after a total knee replacement? A systematic review of mixed methods studies

Khatri,

Ahmed,

Dhaif

et al. 2023

Arch Orthop Trauma Surg

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“…We intentionally adopted wide inclusion criteria to capture a broad range of noninflammatory musculoskeletal pain conditions. This approach represents an extension of earlier disease-specific reviews (11,13,14,16,17) and nonsystematic reviews (18,19). Adopting inclusion criteria that consider a range of conditions is important in the context of co-and multimorbidity of pain conditions (87) and enables a more comprehensive understanding of the impact of a chronic pain experience, agnostic to diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…However, our understanding of the association between chronic noninflammatory musculoskeletal pain conditions and sexual function or intimate relationships remains limited. Existing systematic review-level evidence is limited to fibromyalgia (FM) (11) and postoperative outcomes for joint arthroplasty (12)(13)(14), and nonsystematic review evidence for FM, musculoskeletal pain, and hip arthroplasty outcomes (15)(16)(17)(18)(19). While there will be factors common to all pain conditions that influence sexual function, there may be important disease-specific differences, such as between inflammatory and noninflammatory conditions.…”

Section: Introductionmentioning

confidence: 99%

Chronic Primary or Secondary Noninflammatory Musculoskeletal Pain and Disrupted Sexual Function and Relationships: A Systematic Review

Briggs

Slater

Doornum

et al. 2022

Arthritis Care & Research

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Objective. Evidence points to the impact of chronic musculoskeletal pain conditions on sexual function, yet there is little systematic appraisal and synthesis of evidence examining these associations across noninflammatory conditions. We aimed to systematically review evidence surrounding the association between chronic primary and chronic secondary musculoskeletal pain with intimate relationships and sexual function.Methods. Four electronic databases were searched from January 1, 1990 to September 5, 2019 for cross-sectional or prospective epidemiologic and qualitative studies among cohorts with chronic primary or secondary noninflammatory musculoskeletal pain, defined by International Classification of Diseases, Eleventh Revision classification criteria.Results. Fifty-one eligible studies were included (46 quantitative, 3 qualitative, 2 mixed-methods designs). Sample sizes ranged from 13 to 12,377 and mean age from 32.6 to 69.2 years. Cross-sectional controlled cohort studies consistently reported poorer sexual function outcomes among cohorts with pain relative to comparison groups. Of 15 studies reporting outcomes for the Female Sexual Function Index, 14 demonstrated mean scores of ≤26.55 for the pain group, indicating sexual dysfunction. In 4 studies reporting the International Index of Erectile Function, the pain cohorts demonstrated consistently lower mean subscale scores and the erectile function subscale scores were ≤25.0, indicating erectile dysfunction. Three key themes emerged from a meta-synthesis of qualitative studies: impaired sexual function; compromised intimate relationships; and impacts of pain on sexual identity, body image, and self-worth.Conclusion. Sexual dysfunction and negative impacts on intimate relationships are highly prevalent among people with chronic noninflammatory musculoskeletal pain. Consideration of these associations is relevant to the delivery of holistic, person-centered musculoskeletal pain care.

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“…Our findings suggest that in addition to being a desired outcome, a healthy sexual life before surgery may also be a protective factor associated with better functional results after TKA. As pointed out by a systematic review [28], TKA patients can expect to return to sexual activity an average of 2.4 months following surgery, and improvements in sexual activity are likely to be greater in younger patients and to increase over time. As this is the first study to investigate the relationship between preoperative sexual problems and TKA outcomes, our results point to the need for future studies to investigate this topic more in-depth and with more specific measurements.…”

Section: Plos Onementioning

confidence: 99%

High pre- and postoperative symptom burden in non-responders to total knee arthroplasty

et al. 2020

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ObjectivesOne in five patients does not improve in pain with walking (non-responders) 12 months after total knee arthroplasty (TKA). This longitudinal study investigated a broad range of symptoms before and after TKA and evaluated possible differences in symptom distress between responders and non-responders with regards to pain with walking after TKA. MethodsPrior to TKA surgery, 182 patients completed a demographic questionnaire and the Memorial Symptom Assessment Scale-Short Form (MSAS-SF). The MSAS-SF was repeated 12 months following TKA. Clinical data were extracted from medical records. Patients were categorized as responders or non-responders based on their trajectories of pain with walking assessed prior to surgery, on postoperative day 4, at 6 weeks, and at 3 and 12 months. ResultsOverall, the most distressful preoperative symptoms were pain, lack of energy, difficulty sleeping, feeling drowsy, worrying, feeling bloated, and problems with sexual interest or activity. However, compared with patients classified as responders to TKA, non-responders had higher total symptom distress scores both preoperatively and 12 months postoperatively. Preoperatively, non-responders scored higher than responders on five of the seven most distressing symptoms (i.e., all except difficulty sleeping and feeling bloated), and 12 months postoperatively, non-responders scored higher than responders on six of the seven most distressing symptoms (i.e., all but feeling bloated). In a multivariate analysis, higher preoperative distress scores for pain and problems with sexual interest or activity were significant predictors of non-response to TKA, controlling for other relevant factors.

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Patients experience mixed results with respect to sexual quality and frequency after total knee arthroplasty: a systematic review

Cited by 4 publications

References 59 publications

What’s important for recovery after a total knee replacement? A systematic review of mixed methods studies

What’s important for recovery after a total knee replacement? A systematic review of mixed methods studies

Chronic Primary or Secondary Noninflammatory Musculoskeletal Pain and Disrupted Sexual Function and Relationships: A Systematic Review

High pre- and postoperative symptom burden in non-responders to total knee arthroplasty

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