Rapid multifocal chondrolysis after liver transplantation in four patients.
BACKGROUND
Favourable clinical outcomes achieved with liver transplantation may be jeopardised by corticosteroid-induced osteoarticular complications, such as osteoporosis or aseptic osteonecrosis.


METHODS
A previously unreported joint complication in liver transplant recipients is described.


METHODS
Retrospective study of liver transplant recipients in whom destructive joint disease developed, identified among 330 symptomatic patients out of a total of 1260 managed over a 15 year period (November 1984-January 2000) in a university based liver transplantation centre.


RESULTS
In four patients (23-56 years), rapid chondrolysis developed 2-12 years after transplantation in more than three weightbearing or non-weightbearing joints free of radiological features of avascular osteonecrosis, evidence of infection, or defined inflammatory arthritis. Pathological examination of five hip joints and one knee joint found no evidence of infection or inflammation. Six joint replacement procedures were performed successfully in three patients.


CONCLUSIONS
Clinicians managing liver transplant recipients, and perhaps recipients of other organs, should be aware that rapid chondrolysis may develop. The pathogenesis of this rare complication is unclear.
Taillandier
J
J
Service de Gérontologie et Réadaptation Fonctionnelle, Hôpital Paul Brousse, Assistance Publique-Hôpitaux de Paris (AP-HP), Villejuif, France.
Alemanni
M
M
Samuel
D
D
Bismuth
H
H
Lioté
F
F
D000328:Adult; D002357:Cartilage Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies