Assessing Sexual and Functional Outcomes After Direct Anterior Approach Total Hip Arthroplasty: Insights from a Retrospective Study.

Abstract

The direct anterior approach (DAA) is favored for its muscle-sparing benefits and rapid recovery after total hip arthroplasty (THA). While functional outcomes are well-documented, the impact of DAA THA on sexual health remains underexplored. This study evaluates the resumption of sexual activity and functional recovery in male patients following DAA THA. A retrospective review of male patients who underwent DAA THA (January 2023 and December 2023) was assessed pre- and post-operatively (2 weeks, 12 weeks, and 1-year) for sexual function using the Sexual Health Inventory for Men (SHIM) and hip functionality through the Harris Hip Score (HHS). Statistical significance was set at <i>p</i> < 0.05. Among 64 patients (mean age: 31.4 ± 4.9 years), 73.5% resumed sexual activity within 2 weeks, rising to 95% by 12 weeks. Of those sexually active within 2 weeks, 93% reported a SHIM score of ≥ 20. By 1 year, all patients resumed sexual activity with a mean SHIM score of 23.5. Functional recovery showed a significant improvement in HHS from 39.3 ± 1.4 pre-operatively to 98.9 ± 0.9 at 1 year (<i>p</i> < 0.05). Minor complications, including superficial wound dehiscence (<i>n</i> = 2), were conservatively managed, with no dislocations or major complications reported. DAA THA improves hip function and early resumption to sexual activity, an essential yet overlooked aspect in younger male patients. With 95% resuming sexual activity within 12 weeks and full functional restoration by 1 year, DAA THA proves as a safe and effective approach, making it an ideal choice for active, young individuals seeking physical and personal well-being after surgery.