Pregnancy after total hip arthroplasty

Background: Younger patients are having total hip arthroplasty now, and a w oman 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 preg nancy 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 replacement s, had six successful pregnancies. The mean age at the arthroplasty was twe nty-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 se ven 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 t welve years) for Group B. Patients were clinically evaluated with the Harri s hip score. Radiographs were evaluated for component fixation and osteolys is. Results: The five women completed a total of six successful pregnancies. On e patient, with a bilateral total hip arthroplasty, had two successful preg nancies, 2.5 years apart. Three children were delivered vaginally (with the mother in the lithotomy position) and three, by cesarean section. There we re no complications related to the total hip arthroplasty after delivery. T he mean weight gain during the pregnancy was 13 kg (range, 8 to 14.2 kg). I n Group A, the mean Harris hip score was 94 points prior to the pregnancy a nd 97 points at the time of the most recent follow-up. In group 13, the mea n 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 degrees in Group A before the pregnancy and 241 degre es at the time of the most recent follow-up. The mean total arc of hip moti on was 193 degrees in Group B at one to two years postoperatively and 190 d egrees at the time of the most recent follow-up. The difference in the tota l arc of hip motion between the two groups at the latest follow-up evaluati on 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 th ree hips in Group B. Conclusions: It appears that successful pregnancy and normal vaginal delive ry can occur safely after total hip arthroplasty. The overall result, funct ion, and radiographic appearance after the total hip arthroplasty was not a dversely affected by pregnancy in this small group of patients.