A patient two months after a posterior approach total hip arthroplasty asks about resuming sexual activity. What is the most appropriate role for the physical therapist?

• A. Inform that sexual activity is not appropriate following a total hip arthroplasty
• B. Educate the patient about how to avoid contraindicated movements during sexual activity
• C. Refer the patient back to the orthopedic surgeon to discuss appropriate sexual positions
• D. Refer the patient back to the primary care physician to discuss alternatives to sexual activity

Answer: (B)

Helping a patient safely resume sexual activity after a posterior approach total hip arthroplasty centers on educating them about movements that could compromise healing. The most appropriate role for the physical therapist is to explain how to avoid contraindicated hip movements during sex. After this approach, dislocation risk is tied to certain hip positions, especially flexion, adduction, and internal rotation. By guiding the patient on movements to avoid and suggesting safer positions that keep the hip in neutral alignment and minimize deep flexion or inward turning, the therapist enables a gradual, safe return to intimacy. This education is within the PT’s scope, and the therapist can tailor guidance to the patient’s healing stage and surgeon’s precautions, consulting the surgeon if there are uncertainties about specific limits.