Sierra R J, Trousdale R T, Cabanela M E
Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
J Bone Joint Surg Br. 2005 Jan;87(1):21-4. doi: 10.1302/0301-620x.87b12.16914.
We surveyed 343 young women with 420 total hip arthroplasties (THAs) regarding pregnancy and childbirth after THA. The mean age at surgery was 35 years (18 to 45). The mean length of follow-up after the initial arthroplasty was 16 years (6 to 27). Of these 343 women, 47 (13.7%) had a successful pregnancy after their primary THA. The first baby after a THA was delivered vaginally in 30 patients and by Caesarean section in 17. Of the 343 patients, 138 underwent a revision. For the entire series, the risk of revision at five years was 5%, at ten years 24%, and at 20 years 50%. After adjusting for age at surgical intervention, the risk of revision was not significantly associated with childbirth. Of the 47 patients who had a successful pregnancy, 28 (60%) noted an increase in pain in the hip during pregnancy and ten of these patients had persistent pain after their pregnancy. Seven patients complained of pain in the groin in the replaced hip after childbirth. At the time of this survey, five of these patients (70%) had had revision THA. Childbirth is not affected by the presence of a THA. Pregnancy after THA is not associated with decreased survival of the prosthesis. Pain in the hip is common during pregnancy in these patients. Pain in the groin which persists after delivery commonly leads to revision of the THA.
我们对343名接受了420次全髋关节置换术（THA）的年轻女性进行了关于THA术后妊娠和分娩情况的调查。手术时的平均年龄为35岁（18至45岁）。初次关节置换术后的平均随访时间为16年（6至27年）。在这343名女性中，47名（13.7%）在初次THA术后成功怀孕。THA术后的第一个婴儿，30例经阴道分娩，17例经剖宫产分娩。在343例患者中，138例接受了翻修手术。对于整个系列患者，5年时的翻修风险为5%，10年时为24%，20年时为50%。在对手术干预时的年龄进行调整后，翻修风险与分娩无显著相关性。在47例成功怀孕的患者中，28例（60%）在怀孕期间注意到髋关节疼痛加剧，其中10例患者在产后仍持续疼痛。7例患者在产后抱怨置换髋关节处腹股沟疼痛。在本次调查时，这些患者中有5例（70%）接受了THA翻修手术。分娩不受THA的影响。THA术后妊娠与假体生存率降低无关。这些患者在怀孕期间髋关节疼痛很常见。产后持续存在的腹股沟疼痛通常会导致THA翻修。
