Osteonecrosis following renal transplantation

Subarticular osteonecrosis has been described with increasing frequency after renal transplantation and the use of immunosuppressive corticosteroids. Six cases have been encountered among 170 patients in the Johannesburg renal transplantation programme. The commonly affected sites are the femoral head, the femoral condyles, the humeral head, the talus and the capitulum. The radiological and morbid anatomical features of this complication are described, alternative theories of pathogenesis are considered and an approach to treatment is outlined.