Total hip replacement in renal transplant patients.
Avascular necrosis of the femoral head creates considerable morbidity in successful renal transplant recipients who are generally young and expect active lifestyles. Total hip replacement is considered the treatment of choice in these patients, but surgeons may be wary because of a supposed increase in the risk of infection and other complications. A review of the literature reveals that cemented hip arthroplasty provides good to excellent functional outcomes for renal transplant patients. Most authors have found that the risk of infection is not increased despite chronic immunosuppression, but the rates of general complications are and should be anticipated and treated. There is a high rate of early failure in these patients because of their young age and diffuse osteopenia as a result of secondary hyperparathyroidism related to the underlying renal disease and chronic steroid use. Recent studies have found that despite decreased bone stock in these patients, porous-coated prostheses are not contraindicated.
Department of Orthopedics, University of Toledo Medical Center, 3065 Arlington Avenue, Dowling Hall, Toledo, Ohio 43614, USA.
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Nowicki
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Chaudhary
D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D005271:Femur Head Necrosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016030:Kidney Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D011475:Prosthesis Failure; D016896:Treatment Outcome
D007166:Immunosuppressive Agents