Total hip replacement in renal transplant patients

Area of Science:

• Orthopedic surgery
• Nephrology
• Transplantation medicine

Background:

• Avascular necrosis of the femoral head (AVNFH) causes significant morbidity in renal transplant recipients.
• These patients are typically young with active lifestyle expectations.
• Total hip replacement (THR) is the preferred treatment, but concerns about complications exist.

Purpose of the Study:

• To evaluate the efficacy and safety of total hip replacement for AVNFH in renal transplant recipients.
• To assess the risks of infection and other complications in this patient population.
• To review the outcomes of different arthroplasty techniques in renal transplant recipients.

Main Methods:

• A comprehensive review of existing literature on hip arthroplasty in renal transplant recipients.
• Analysis of functional outcomes, infection rates, and general complication rates.
• Evaluation of prosthesis types, including cemented and porous-coated implants.

Main Results:

• Cemented hip arthroplasty demonstrates good to excellent functional outcomes in renal transplant patients.
• The risk of infection is not significantly increased despite chronic immunosuppression.
• Higher rates of general complications are observed and require proactive management.
• Early failure can occur due to young age and osteopenia from renal disease and steroid use.
• Porous-coated prostheses are suitable despite reduced bone stock.

Conclusions:

• Total hip replacement is a viable and effective treatment for AVNFH in renal transplant recipients.
• Surgeons should anticipate and manage general complications, but infection risk is not a contraindication.
• Both cemented and uncemented (porous-coated) implants can yield successful outcomes.