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Dr. Swanson
Re: pregnancy after hip replacement
Mon May 28, 2007 11:44am

I’m confused as to why you would be made toe touch weight bearing 8 months post-op. Was that done because of the pregnancy? In general, it is agreed by almost all orthopaedic surgeons that a patient can be full weight-bearing no later than 6 weeks post-op, and many of us allow our patients to be full weight-bearing immediately. I can’t imagine why your surgeon would now make you toe touch weight-bearing, unless there is something else going on that I am not fully understanding from your post. (I certainly would not try to second guess your surgeon’s judgment without having all the facts of your case). Most of us also agree that one should remain active after total hip replacement, even when pregnant. Pregnancy should not preclude a normal, active lifestyle or physical therapy.

Additionally, almost all female patients are able to have normal vaginal deliveries after total hip replacement. Only rare exceptions exist in patients with severe anatomical abnormalities or hardware which may protrude into the birth canal. During the delivery itself, the mother’s legs are normally positioned in the safest position available to avoid dislocation—abduction combined with external rotation (commonly known as the “lithotomy position”).

One issue which is relevant to pregnancy, by the way, is the issue of metal ions generated from metal on metal bearing surfaces such as used in hip resurfacings or large ball and socket hip replacements. It is generally accepted by all of us that metal on metal hip replacements should not be used in women of child-bearing age because of the potential harmful effects of the metal ions on the developing fetus. Metal ions DO cross the placenta, entering the fetal circulation, and although the exact effects of these ions on the fetus are unknown, it is worrisome enough that it is best to avoid metal on metal hip replacements in women who may be planning on becoming pregnant.

Todd Swanson, MD

  • Re: pregnancy after hip replacementStacy R. Grenier, Wed May 23 7:28pm
    I am a 30 year old female with a THR and I am 12 weeks pregnant. I am 8 months post-op and I have been put on toe touch weight wearing only for the past month. I have been told that I can not do any... more
    • Re: pregnancy after hip replacement — Dr. Swanson, Mon May 28 11:44am
      • Hip replacement and pregnancyStacy R. Grenier, Mon May 28 1:06pm
        Hello, Thank you for your response. I was tolal weight bearing at 6 weeks post op. and was fine until Nov 06 when I had a fall. I was still total weight bearing, but I was taking Ibuprofin quite... more
        • hip replacement & pregnancyTodd Swanson, MD, Sat Jun 2 4:52pm
          Well, unfortunately, it sounds like your physician suspects that you have a loose femoral component. I would have to agree from your description. In general, it is best to avoid radiographs while... more
    • pregnancy after hip replacementAnita, Thu May 24 2:57am
      I recently had my second child, c-section, which was about a year and a half after my total hip replacement. I was diagnosed with avascular necrosis in my right hip 2 months after my first child. Now ... more
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