Convalescent Rehabilitation after Hemiarthroplasty for a Displaced Femoral Neck Fracture in a Sexually Active Older Adult Gay Man
Keywords:
femoral neck fracture; hemiarthroplasty; rehabilitation; gay; sexual positioningAbstract
Background: Our patients include individuals who are lesbian, gay, bisexual, and transgender and comprise between 0.5% and 10% of the total population. Case Presentation: A 79-year-old man was transferred to our convalescent rehabilitation ward after undergoing hemiarthroplasty (HA) to treat a right-sided displaced femoral neck fracture. His rehabilitation protocol included strengthening of the lower limb muscles; balance, gait, and endurance exercises; and activities of daily living (ADL) training. Because he was a sexually active gay man who engaged in receptive anal intercourse (RAI), we also recommended positions for sexual intercourse to prevent dislocation. Discussion and Conclusion: Dislocation is a serious complication after HA and total hip arthroplasty (THA) that may be induced by sexual intercourse in elderly patients. In convalescent rehabilitation, guidance regarding sexual activity should be provided to all patients undergoing HA and/or THA to prevent dislocation, regardless of their age and sex. In men undergoing HA and/or THA, sexual positions of both men and women
References
Orel, NA. (2014) Investigating the need and concerns of lesbian, gay, bisexual, and transgender older adults: the use of qualitative and quantitative methodology. J Homosex, 61(1): 53-78.
Fredriksen-Goldsen, KI., Kim, HJ., Shiu, C., Goldsen, J., Emlet, CA. (2015) Successful aging among LGBT older adults: physical and mental health-related quality of life by age group. Gerontologist, 55(1): 154-168.
Caceres, BA., Frank, MO. (2016) Successful ageing in lesbian, gay and bisexual older people: a concept analysis. Int J Older People Nurs, 11(3): 184-193.
Ikuta, N., Koike, Y., Aoyagi, N., Matsuzaka, A., Fuse-Nagase, Y., Kogawa, K., et al. (2017) Prevalence of lesbian, gay, bisexual, and transgender among Japanese university students: a single institution survey. Int J Adolesc Med Health, 29(5): 20150113.
Stinchcombe, A., Smallbone, J., Wilson, K., Kortes-Miller, K. (2017) Healthcase and end-of-life needs of lesbian, gay, bisexual, and transgender (LGBT) older adults: a scoping review. Geriatrics, 2(1): 13.
Stults, CB., Grov, C., Anastos, K., Kelvin EA., Patel, VV. (2020) Characteristics associated with trust in and disclosure of sexual behavior to primary care providers among gay, bisexual, and other men who have sex with men in the United States. LGBT Health, 7(4): 208-213.
Hatzenbuehler, ML., Bellatorre, A., Lee, Yeonjin., Finch, B., Muennig, P., Fiscella, K. (2014) Structural stigma and allcause mortality in sexual minority populations. Soc Sci Med, 103: 33-41.
Wang, F., Zhang, H., Zhang, Z., Ma, C., Feng, X. (2015) Comparison of bipolar hemiarthroplasty and total hip arthroplasty for displaced femoral neck fractures in the healthy elderly: a meta-analysis. BMC Musculoskelet Disord, 16: 229.
Liu, Y., Chen, X., Zhang, P., Jiang, B. (2020) Comparing total hip arthroplasty and hemiarthroplasty for the treatment of displaced femoral neck fracture in the active elderly over 75 years old: a systematic review and meta-analysis of randomized control trials. J Orthop Surg Res, 15: 215.
Guyen, O. (2019) Hemiarthroplasty or total hip arthroplasty in recent femoral neck fractures?. Orthop Traumatol Surg Res, 105(1S): S95-S101.
Couch, CG., Nicholas, RW., Montgomery, CO. (2018) Safe positioning for sexual intercourse after proximal femoral replacement. Orthopedics, 41(2): e292-e294.
Lu, Y., Xiao, H., Xue, F. (2019) Causes of and treatment options for dislocation following total hop arthroplasty. Exp Ther Med, 18(3): 1715-1722.
Dangerfield, DT. 2nd, Smith, LR., Williams, J., Unger, J., Bluthenthal, R. (2017) Sexual positioning among men who have sex with men: a narrative review. Arch Sex Behav, 46(4): 869-884.
McInnis, MK., Pukall, CF. (2020) Sex after prostate cancer in gay and bisexual men: a review of the literature. Sex Med Rev. 8(3): 466-472.
Charbonnier, C., Chagué, S., Ponzoni, M., Bernardoni, M., Hoffmeyer, P., Christofilopoulos, P. (2014) Sexual activity after total hip arthroplasty: a motion capture study. J Arthroplasty, 29(3): 640-647.
