Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: Women of childbearing age undergo total hip arthroplasty (THA), yet little is known about effect of pregnancy on THA. We compared patients with a post-THA pregnancy to those with a pregnancy pre-THA or nulliparous.
Methods: Women ages 18-45 enrolled in an arthroplasty registry between 5/1/07 and 12/31/11 were identified. Information about the first pregnancy post-THA and the last pregnancy pre- THA was queried for demographics, WOMAC, and the HSS Expectations Score. 3 groups: nulliparous, pregnancy pre-THA, pregnancy post-THA
Results: 325 eligible women identified; 171 (52.6%) responded, no significant differences between responders and non-responders. 79 women (46.2%) were never pregnant, 82 (47.4%) had pregnancy pre-THA and 10 (6.4%) had a completed pregnancy post-THA. Women with pregnancy pre-THA were older (40.7 years SD 4.3) than post-THA, (37.2 years SD 4.2) or nulliparous, (35.0 years SD 7.9) p -value<0.001. THA were performed for hip dysplasia (28.1%), osteoarthritis (26.3%), inflammatory arthritis (24.0%), osteonecrosis (15.2%), fracture (5.8%) and other (1.1%). There was no difference in race, education, BMI, or reason for THA. Time between delivery and THA: 85.3 months (SD 66.1) for pre-pregnancy THA; 25.6 months (SD 7.9) for post-THA pregnancy. There were no differences in birth weight, parity, weight gain, or pregnancy complications. There was no difference in delivery; vaginal (64% vs. 88% p-value=0.58), Cesarean (25% vs. 3% p-value=0.58). There were no significant differences in pre-operative or post-THA WOMAC, Expectations or satisfaction (p-value=0.61). There were no differences for groin, back or knee pain during pregnancy. 90% reported “great” or “more improvement than I ever dreamed” in quality of life after THA.
Conclusion: There were no differences in post-operative pain, function or quality of life between women with post-THA pregnancy, pre-THA pregnancy, or nulliparous women, and no differences in pregnancy outcomes or complications. Pregnancy following THA had no adverse effects on pain or function.
|
|
No pregnancy (N=79) |
Pregnancy pre THA (N=82) |
Pregnancy post THA (N=10) |
P value |
|
|
|
|
|
|
|
Age, yr (SD) |
35.0 (7.9) |
40.7 (4.3) |
37.2 (4.2) |
<0.001 |
|
Race, n (%) |
|
|
|
0.35 |
|
Caucasian |
63 (81) |
69 (85 ) |
9 (90) |
|
|
Hispanic, n (%) |
12 (16) |
6(8) |
1 (10) |
0.29 |
|
Education level, n (%) |
|
|
|
0.83 |
|
High school graduate |
4 (6) |
4 (6) |
2 (25) |
|
|
College graduate |
28 (42) |
28 (41) |
3 (38) |
|
|
Masters/professional degree |
22 (33) |
25 (36) |
2 (25) |
|
|
Reason for THA surgery, n (%) |
|
|
|
0.17 |
|
Inflammatory arthritis |
24 (30) |
12 (15) |
4 (40) |
|
|
Osteoarthritis |
18 (23) |
24 (30) |
3 (30) |
|
|
Fracture |
4 (5) |
4 (5) |
1 (10) |
|
|
Congenital hip dysplasia |
21 (27) |
25 (31) |
2 (20) |
|
|
Osteonecrosis |
10 (13) |
16 (20) |
0 |
|
|
Other |
2 (2) |
0 |
0 |
|
|
Deyo comorbidity |
|
|
|
0.69 |
|
0 |
61 (78) |
66 (84) |
5 (83) |
|
|
1-2 |
17 (22) |
13 (16) |
1 (17) |
|
|
WOMAC pre-THA |
|
|
|
|
|
Pain, mean (SD) |
50.5 (20.2) |
50.4 (18.0) |
60.0 (15.8) |
0.61 |
|
Function, mean (SD) |
48.9 (20.3) |
51.7 (18.3) |
54.7 (15.8) |
0.63 |
|
Expectation score, mean (SD) |
81.1 (14.7) |
86.5 (12.9) |
86.8 (12.8) |
0.13 |
|
WOMAC post-THA |
|
|
|
|
|
Pain, mean (SD) |
85.2 (18.8) |
84.9 (15.8) |
92.5 (5.9) |
0.4 |
|
Function, mean (SD) |
87.6 (22.1) |
91.1 (15.3) |
93.5 (6.4) |
0.39 |
|
Overall THA satisfaction |
|
|
|
0.62 |
|
Very satisfied, n (%) |
40 (87) |
70 (86) |
9 (90) |
|
|
Very dissatisfied, n (%) |
0 |
1 (1) |
0 |
|
|
Pregnancy |
|
|
|
|
|
Age at pregnancy, yr (SD) |
|
40.7 (4.3) |
37.2 (4.2) |
0.06 |
|
Weight gain, lbs (SD) |
|
35.1 (19.2) |
30.1 (13.6) |
0.48 |
|
Uncomplicated delivery, n (%) |
|
62 (78) |
8 (89) |
0.46 |
|
Vaginal delivery, n (%) |
|
52 (64) |
7 (88) |
0.58 |
|
Elective Cesarean, n (%) |
|
20 (25) |
1 (13) |
0.58 |
|
Unanticipated Cesarean, n (%) |
|
7 (9) |
0 |
0.58 |
|
Singletons |
|
77 (95) |
9 (90) |
0.51 |
|
Twins |
|
4 (5%) |
1 (10) |
0.51 |
|
Weight of baby, lbs (SD) |
|
7.5 (1.5) |
7.3 (0.6) |
0.8 |
|
Back pain, n (%) |
|
36 (45) |
5 (56) |
0.55 |
|
Groin pain, n (%) |
|
17 (22) |
1 (11) |
0.46 |
|
Knee pain, n (%) |
|
11 (14) |
2 (22) |
0.52 |
|
Parity at time of survey response |
|
|
|
0.34 |
|
1, n (%) |
|
29 (35) |
4 (44) |
|
|
2, n (%) |
|
31 (38) |
4 (44) |
|
|
3, n (%) |
|
19 (23) |
0 |
|
|
>3, n (%) |
|
3 (4) |
1 (11) |
|
|
WOMAC scale: 1-100; higher is better |
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|
|
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Disclosure:
L. Lally,
None;
L. A. Mandl,
Boehringer Ingelheim,
2;
R. Zhu,
None;
W. T. Huang,
None;
M. P. Figgie,
Mekanika,
1,
Ethicon,
2;
M. Alexiades,
None;
S. M. Goodman,
None.
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