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Total hip replacement in the renal transplant recipient
P J Radford1, A Doran, R A Greatorex
1Orthopaedic Research Unit, Addenbrooke's Hospital, Cambridge, England.
Summary
Total hip replacement is a safe and effective treatment for renal transplant patients experiencing femoral head osteonecrosis due to steroid immunosuppression. Early consideration of this procedure is recommended given their limited life expectancy.
Area of Science:
- Orthopedics
- Nephrology
- Immunology
Background:
- Osteonecrosis of the femoral head is a debilitating complication in renal transplant recipients, often linked to long-term steroid immunosuppression.
- This condition can lead to severe disability and impact the quality of life in these patients.
Purpose of the Study:
- To evaluate the safety and efficacy of total hip arthroplasty (THA) in renal transplant recipients with femoral head osteonecrosis.
- To assess outcomes and complications associated with THA in this specific patient population.
Main Methods:
- A retrospective review of 31 total hip arthroplasties performed in 21 renal transplant recipients.
- Average follow-up duration of six years, with assessment of wound healing, infection, implant loosening, and overall functional outcomes.
Main Results:
- No instances of wound healing problems or infection were observed, despite patients being on full immunosuppression.
- Four hips (12.9%) experienced symptomatic loosening, while the remaining outcomes were rated as excellent.
- The results demonstrated favorable comparison with other treatments for osteonecrosis.
Conclusions:
- Total hip replacement is a safe and effective surgical option for managing femoral head osteonecrosis in renal transplant recipients.
- Given the potentially limited life expectancy of these patients, early consideration of THA should be explored as a treatment strategy.