Improvements in Sexual Function Following Arthroscopic Rotator Cuff Repair.J Shoulder Elbow Surg. 2020 Jul 07 [Online ahead of print]JS
Three-fourths of Americans are sexually active and studies show a correlation between sexual activity and good health. Rotator cuff tears and subsequent repairs can cause significant disruption in daily living including sexual activity. Orthopedic surgeons rarely discuss sexual activity with patients. Therefore, patients have little information about expectations, restrictions, and return to sexual activity. The primary goal of this study is to evaluate patient improvement in sexual activity following arthroscopic rotator cuff repair and evaluate factors that affect sexual activity.
An anonymous 20-item multiple-choice survey was sent to patients greater than six-months following arthroscopic rotator cuff repair performed by seven fellowship trained orthopedic shoulder and elbow surgeons between March 2018 and May 2019. The survey assessed preoperative and postoperative sexual activity, and included questions regarding frequency, pain, positioning, and postoperative injury.
A total of 88 patients met inclusion criteria and completed the survey. Preoperatively, 65% of patients admitted that their shoulder interfered with the quality and/or frequency of their sexual activity, most commonly secondary to inability to weight bear on the affected arm (31%). Postoperatively, the majority of patients (79%) found it easier to engage in sexual activity, with 35% of patients attributing this to less pain. At six weeks postoperative, 72% of patients returned to sexual activity. The overall trend demonstrated a statistically significant (p<0.001) increase in sexual activity frequency as one progressed from their operative date. Interestingly, 31% of patients removed their sling to engage in sexual activity following surgery, with 7% admitting to aggravating their shoulder or causing significant pain.
Prior to arthroscopic rotator cuff repair, most patients experience limitations in the quality and/or frequency of their sexual activity secondary to their shoulder. Following surgery, the majority of patients will more easily engage in sexual activity by 6 weeks, with increasing frequency as time progresses from surgery. Many patients are non-compliant with sling wear during sexual activity and 7% will aggravate their shoulder.