RESEARCH - Pregnancy after total hip arthroplasty

[Guest guest]

J Bone Joint Surg Am. 2001 Oct;83-A(10):1490-4.

Pregnancy after total hip arthroplasty.

McDowell CM, Lachiewicz PF.

Department of Orthopaedics, University of North Carolina School of Medicine,

Chapel Hill 27599, USA.

BACKGROUND: Younger patients are having total hip arthroplasty now, and a

woman who has had such a procedure may want to become pregnant. The purposes

of this study were to report on a series of women who had completed a

pregnancy after a total hip arthroplasty and to determine if pregnancy

affects the function and longevity of the prosthesis. METHODS: Five women,

with a total of seven uncemented total hip replacements, had six successful

pregnancies. The mean age at the arthroplasty was twenty-nine years (range,

twenty-two to thirty-eight years), and the mean time from the hip

arthroplasty to the pregnancy was 2.5 years (range, one to seven years).

These patients (Group A) were compared with a matched group of five women

with a total of eight uncemented total hip prostheses (Group who had not

completed a pregnancy. The mean follow-up time was eight years (range, two

to thirteen years) for Group A and seven years (range, two to twelve years)

for Group B. Patients were clinically evaluated with the hip score.

Radiographs were evaluated for component fixation and osteolysis. RESULTS:

The five women completed a total of six successful pregnancies. One patient,

with a bilateral total hip arthroplasty, had two successful pregnancies, 2.5

years apart. Three children were delivered vaginally (with the mother in the

lithotomy position) and three, by cesarean section. There were no

complications related to the total hip arthroplasty after delivery. The mean

weight gain during the pregnancy was 13 kg (range, 8 to 14.2 kg). In Group

A, the mean hip score was 94 points prior to the pregnancy and 97

points at the time of the most recent follow-up. In group B, the mean

hip score was 91 points at one to two years after the arthroplasty and it

was unchanged at the time of the most recent follow-up. There were six

excellent results and one good result of the hip arthroplasty in Group A and

five excellent and three good results in Group B. The mean total arc of hip

motion was 217 degrees in Group A before the pregnancy and 241 degrees at

the time of the most recent follow-up. The mean total arc of hip motion was

193 degrees in Group B at one to two years postoperatively and 190 degrees

at the time of the most recent follow-up. The difference in the total arc of

hip motion between the two groups at the latest follow-up evaluation was

significant (p = 0.025). There were no reoperations in either group.

Radiographs showed osteolysis of the femur in three hips in Group A and

three hips in Group B.

CONCLUSIONS: It appears that successful pregnancy and normal vaginal

delivery can occur safely after total hip arthroplasty. The overall result,

function, and radiographic appearance after the total hip arthroplasty was

not adversely affected by pregnancy in this small group of patients.

PMID: 11679598

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ct & list_uids=11679598

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org