Pregnancy Does Not Adversely Affect Postoperative Pain and Function in Women With Total Hip Arthroplasty.

Age at time of THA, mean (SD), y 35 (7.9) 40.7 (4.3) 37.3 (4.3) <0.001 Time fromTHA to survey response,mean (SD),mo 36.5 (27.3) 34.9 (11.7) 39.5 (15.6) 0.24 Preoperative bodymass index, mean (SD), kg/m 25.6 (5.9) 25.4 (4.9) 23.6 (2.0) Race, n (%) 0.35 White 63 (81) 69 (85) 9 (90) Hispanic 12 (16) 6 (8) 1 (10) 0.29 Education level, n (%) 0.83 High school 4 (6) 4 (6) 2 (20) College graduate/advanced degree 50 (63) 53 (65) 5 (50) 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 Primary THA, n (%) 67 (85) 77 (96) 10 (100) 0.31 Deyo comorbidity 0.69 0 61 (78) 66 (84) 5 (83) >1 17 (22) 13 (16) 1 (17) WOMAC pain Pre-THA, mean (SD) 50.5 (20.2) 50.4 (18.0) 60.0 (15.8) 0.61 Post-THA, mean (SD) 85.2 (18.8) 84.9 (15.8) 92.5 (5.9) 0.4 WOMAC function Pre-THA, mean (SD) 48.9 (20.3) 51.7 (18.3) 54.7 (15.8) 0.63 Post-THA, mean (SD) 87.6 (22.1) 91.1 (15.3) 93.5 (6.4) 0.39 Expectation score, mean (SD) 81.1 (14.7) 86.5 (12.9) 86.8 (12.8) 0.13 Overall THA satisfaction 0.62 Very satisfied, n (%) 40 (87) 70 (86) 9 (90) Very dissatisfied, n (%) 0 1 (1) 0 Improvement in quality of life post-THA 0.68 Great improvement, n (%) 42 (53.1) 42 (51.2) 6 (60) C hanging indications and utilization patterns have resulted in shifting demographics of patients receiving total hip arthroplasty (THA) to include younger patients, including women of childbearing potential. There have been concerns that pregnancy following THA could result in prosthetic loosening, dislocation, pain, or functional impairment. While several case series report successful pregnancies following THA, less is known about the effects of pregnancy on pain or function associated with the maternal hip prosthesis. Using a well-characterized cohort from a THA registry at a single highvolume specialty hospital, we compared preoperative and postoperative measures of pain and function in 3 groups of women: those with only pre-THA pregnancies, those with pregnancy post-THA, and those without any pregnancy. Our primary objective was to compare postoperative pain and function in women with different pregnancy histories. Women aged 18 to 45 years enrolled in an institutional THA registry from 2007 to 2011 were identified. Subjects had preoperative pain and function data collected as part of the registry. For this study, subjects received a questionnaire eliciting pregnancy history (defined as gestation lasting >30 weeks) with additional questions about postarthroplasty pain and function. The primary outcomes of interest were postoperative Western Ontario and McMaster UniversitiesOsteoarthritis Index (WOMAC) pain and function scores (0–100, with higher scores indicating better function and less pain). Secondary objectives included pregnancy outcomes, comparing those who had pre-THA pregnancy to those who had postTHA pregnancy. Of 325 eligible women undergoing THA in the study period, 171 women (52.6%) responded to the pregnancyfocused questionnaire. Comparing responders to nonresponders, there were no statistically significant differences between groups in terms of demographics or preoperative baselineWOMAC pain and function scores. Of the responders, 79 women (46.2%) reported being nulliparous, 82