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评估妊娠和分娩前全髋关节置换术的效果及挑战:一项系统评价

Assessing the Effects and Challenges of Total Hip Arthroplasty before Pregnancy and Childbirth: A Systematic Review.

作者信息

Galanis Athanasios, Dimopoulou Stefania, Karampinas Panagiotis, Vasiliadis Elias, Kaspiris Angelos, Sakellariou Evangelos, Vlachos Christos, Vavourakis Michail, Papagrigorakis Eftychios, Marougklianis Vasileios, Tsalimas Georgios, Zachariou Dimitrios, Patilas Christos, Varsamos Iordanis, Kolovos Ioannis, Vlamis John

机构信息

3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, 14561 Athens, Greece.

出版信息

J Funct Morphol Kinesiol. 2024 Apr 4;9(2):63. doi: 10.3390/jfmk9020063.

Abstract

Total hip arthroplasty is indubitably one of the most performed operations worldwide. On the other hand, especially in the western world, the average age that women get pregnant has raised confoundedly. Consequently, a steadily increasing number of women become pregnant after they had hip arthroplasty surgery, with copious potential implications. The amount of knowledge on this particular field is considered inadequate in the existing literature. This paper aims to augment clinicians understanding surrounding this topic. A systematic literature review was conducted in accordance with the PRISMA guidelines. Papers from various computerized databases were scrutinized. Article selection was carried out by three authors independently employing specific pre-determined inclusion and exclusion criteria, while disagreements were elucidated with the contribution of other authors. A patently limited number of research articles were detected from our rigorous literature review, with only 12 papers meeting the inclusion criteria. The vast majority of studies were small-scale and examined confined population groups. Most studies had been performed in Finland, utilizing data from nationwide registries. Women with previous history of total hip arthroplasty feature increased rates of c-section delivery, although vaginal labor can be attempted with certain precautions. Hip implants' survival does not appear to be affected from gestation, which is predominately well-tolerated from these women. Metal ion circulation in mothers' blood has not been proven to trigger substantial complications concerning either mothers or offspring. It can be considered safe for women with such medical history to get pregnant; however, further multinational studies and pertinent research on this field are vital to attain more solid inferences.

摘要

全髋关节置换术无疑是全球实施最为广泛的手术之一。另一方面,尤其是在西方世界,女性的平均怀孕年龄显著提高。因此,越来越多的女性在接受髋关节置换术后怀孕,这带来了诸多潜在影响。现有文献中关于这一特定领域的知识被认为是不足的。本文旨在加深临床医生对该主题的理解。按照PRISMA指南进行了系统的文献综述。对来自各种计算机化数据库的论文进行了仔细审查。文章筛选由三位作者独立进行,采用特定的预先确定的纳入和排除标准,如有分歧则在其他作者的协助下阐明。从我们严格的文献综述中发现的研究文章数量明显有限,只有12篇论文符合纳入标准。绝大多数研究规模较小,且研究对象局限于特定人群。大多数研究在芬兰进行,利用全国登记处的数据。有全髋关节置换术史的女性剖宫产率增加,不过在采取一定预防措施的情况下可以尝试阴道分娩。髋关节植入物的存活率似乎不受妊娠影响,这些女性对妊娠大多耐受性良好。尚未证实母亲血液中的金属离子循环会引发涉及母亲或后代的重大并发症。对于有此类病史的女性来说,怀孕可以被认为是安全的;然而,进一步的多国研究和该领域的相关研究对于得出更可靠的推论至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ebd/11036194/9426668d9e6c/jfmk-09-00063-g001.jpg

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