Hip Resurfacing and Pregnancy
I had mine done by Mr McMinn at the ROH in Birmingham when the procedure was a twinkle in most peoples eyes. I had CDH which was only diagnosed at 4yrs so I had many ops to try to ‘build’ a hip socket but it finally gave up the ghost and I was faced with either a non tried and tested new op or a THR. I didn’t think there was much choice!! I had my left hip resurfaced in September 1991 when I was 21 – Mr McMinn was still pioneering it and I was the youngest person to have it at that time. I had to have bone grafting at the same time so my post op recovery took longer than normal. I was in traction for 4 weeks & crutches for a few months but it meant I could walk down the isle in 1992 with no hint of a limp which made my Mum cry! 2 years later I had my first baby followed by another one 5 years after that. My hip is still going very strong after over 12years..
…My first baby was 2 years post op and the 2nd was 7 years. Both of them are just fine, I had normal pregnancies and they were born perfectly normally, weighing in at a very healthy 8lb 7oz & 9lb respectively. They are now coming up for 12 years and 7 years and none of us have shown any signs of issues from metal ions…
There was just a very good presentation about BHR and pregnancy at the 10 year BHR results meeting in Miami in October presented by Dr. McMinn’s group. Contact Smith and Nephew for the powerpoint and papers. In a nutshell, the placenta does diminish the metal ion concentration that reaches the fetus but does not completely eliminate the exposure. Whether the concentration that does reach the fetus has any detrimental effects is unknown. The general recommendation, however, is to have resurfacing at least 1-2 years prior to pregnancy to allow for the run in period of the metal and get down to the lowest concentrations of metal ions or after the lactating period after birth which I believe would be the safest course.
I’ve spoken with Joseph on this matter and we both agree that advice Mr. McMinn is likely to give is pretty much what we state at presentations.
We quote the data from our BHR longitudinal study which shows and initial increase in metal ions (running-in) but then decreases and continues to fall even at 4 years post op. The advice would be to the Patient, either have the baby before the BHR op, or in this case, wait as long as possible after the operation, at least until after the running-in period which is normally around12-18 months.
While we are on this subject, I would like to take to opportunity to the evidence we discovered on a study group.
We found that the metal ion levels in the mother’s blood were indeed elevated(as expected when there is a M/M bearing) but the corresponding umbilical cord blood metal ion levels, at the time of delivery, were significantly lower..
We would very much like to expand on this study and to do so we need more patients to participate. If Dr. Rogerson has any female patients of child-bearing potential, we would like to know if he is interested in developing this study.
I hope you find this useful.
Kindest regards
The McMinn centre