Scientific Article   |    
Pregnancy After Total Hip Arthroplasty
Cathy M. McDowell, RN; Paul F. Lachiewicz, MD
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Investigation performed at the Department of Orthopaedics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
Cathy M. McDowell, RN
Paul F. Lachiewicz, MD
Department of Orthopaedics, University of North Carolina School of Medicine, 242 Burnett Womack Building, CB 7055, Chapel Hill, NC 27599

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. A commercial entity (Zimmer, Warsaw, Indiana) paid or directed, or agreed to pay or direct, benefits to a research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

J Bone Joint Surg Am, 2001 Oct 01;83(10):1490-1494
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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 B) 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 Harris 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 Harris 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 Harris 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° in Group A before the pregnancy and 241° at the time of the most recent follow-up. The mean total arc of hip motion was 193° in Group B at one to two years postoperatively and 190° 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.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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