Healthy Aging

Hip Replacement Karma Sutra

Modern hip replacements go back almost 40 years and are the most common joint replacement surgery performed, and yet until researchers decided to investigate earlier this year, nobody had taken the trouble to figure out how men and women can have sex after hip surgery without worrying about the risks.

Just how much range of motion does sexual activity involve – and which specific types of activity can dislocate an artificial hip?

The Research

That’s what a team of Swiss-based computer and medical scientists decided to find out, using a motion capture technology – a way of recording real people’s complex movements that’s often used in creating 2- and 3D computer animation. In this case, the team used a pair of human volunteers, a man and a woman.

If the lithe figures in the motion-capture diagram above don’t remind you of you, that may be because the volunteers who were used for this project are much younger – despite the fact that the majority of hip replacements are still performed on older people. Still, hip surgery among active middle-agers has almost doubled in the past decade, leading doctors to pay more attention to sex. As Dr. Charles Cornell at New York’s Hospital for Special Surgery told the Times: “It’s especially important to our younger patients, but believe it or not, I’ve had patients in their 80s who this has been a topic for.”

The Findings

In their recently published paper, “Sexual Activity after Total Hip Arthroplasty,” the Swiss team concludes that sexual positions for women require an intensive range of hip motion, whereas positions for men are fairly risk-free. They asked their volunteers to try 12 common positions and noted that four positions – the ones with the X in the diagram above – require intensive flexion for women and can cause an impingement. A check mark next to a position in the diagram means that it is safe.


6 responses to “Hip Replacement Karma Sutra

  1. No science has not created a gender specific hip implant. Kate, have a hip replacement if you’re miserable. You will find it is life changing. I also don’t think you’ll find that your sex life is negatively impacted, I’m guessing it will be improved. Good luck.

    1. As long as you don’t get nerve damage or a foot drop. I’ve had both over the years, PAO’s, Total Hip, a decision and resurfacing between both hips. They never warn you about how severe the nerve damage can be or what it’s like to live with a foot drop. Talk to patients, not surgeons who never admit when they’re wrong.

  2. I’m getting ready to have a right THR. These issues are making me want to back out and just live with the massive pain, nearly dragging my leg everywhere I go. I’m 42 and it’s severely medically necessary but my poor husband and mostly, poor me! This is so sad and ridiculous that researchers haven’t figured this out. Guess they are wearing the white coat in an R&D lab instead of having sex so they really don’t care. This is crippling. Guess I’ll be in the ER with a dislocated hip every now and then. This absolutely sucks! Not only am I going to have a heinous scar but then I can’t even function sexually on top of it. I’m not old! I guess this is acceptable for a 90 year old but certainly not for me and I don’t plan to quit having sex with my husband for a very long time. Lord, help me.

    1. Kate, I will be 52 in a week. I was scared to have THR, but I had to when it impacted my sex life so much that I could not even do the Missionary position because I couldn’t open my legs. My go to position became laying on my side from behind! I’m too young to not be sexually active! So, I had my right hip done Dec 2, 2021 and left hip done on Dec 3, 2022. The pain from surgery was worth it. The scars are not hideous. They are about 6 inches long on either anterior hips. Sex life has been great!

  3. I really appreciate the subject that you studied. I am a 58 year old woman with double hip replacement for the last two years. I have returned to sexual functioning but the awkward lack of full hip flextion impacts engagement.

    I am wondering if, as usual, medical science has invented a hip joint that basically works better for men than for women.

    I am eternally grateful for walking again and being in less pain, but why can’t an artificial hip be created with female anatomy and sex in mind??

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