title: Osteonecrosis of the femoral head in Japanese adults after liver transplantation: a preliminary report.
abstract: Patients who are treated with high-dose corticosteroids as an immunosuppressive therapy are at high risk of developing osteonecrosis, especially in the femoral head. We examined whether symptomatic osteonecrosis of the femoral head (ONFH) would be a clinical problem after liver transplantation. From June 1990 to December 2001, a total of 169 patients underwent liver transplantation at the Shinshu University Hospital. Within this group, 65 patients were more than 18 years old at the time of surgery, and all were enrolled in the present study. All patients were referred to the Orthopaedic Department of Shinshu University Hospital when they experienced musculoskeletal symptoms, including hip or groin pain. In addition, they were informed of the potential risk of osteonecrosis associated with immunosuppressive therapy after the liver transplant. As result, the patients were advised to have a magnetic resonance imaging (MRI) check for osteonecrosis after transplant surgery. In terms of outcomes, none of the patients presented with symptomatic hip difficulties due to osteonecrosis. Additional clinical investigation revealed that of the 18 patients who underwent MRI screening, only one was found to have asymptomatic unilateral ONFH. In conclusion, ONFH after liver transplantation has not been a clinical problem for our patients.
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Horiuchi
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Hashikura
authors.forename: Kenji
authors.initials: K
authors.lastname: Hisa
authors.forename: Naoto
authors.initials: N
authors.lastname: Saito
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ikegami
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Nakazawa
authors.forename: Osamu
authors.initials: O
authors.lastname: Karakida
authors.forename: Seneki
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Masashi
authors.initials: M
authors.lastname: Nawata
authors.forename: Seiji
authors.initials: S
authors.lastname: Kawasaki
authors.forename: Kunio
authors.initials: K
authors.lastname: Takaoka
mesh_terms: D000328:Adult; D002648:Child; D005260:Female; D005271:Femur Head Necrosis / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology*; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D016031:Liver Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents