Total hip replacement in patients with renal transplants

Area of Science:

• Orthopedic Surgery
• Nephrology
• Rheumatology

Background:

• Renal transplant recipients often require long-term systemic corticosteroid therapy.
• Corticosteroid use is a known risk factor for avascular necrosis (AVN) of the femoral head.
• AVN can cause significant hip pain and functional impairment in these patients.

Purpose of the Study:

• To evaluate the outcomes of total hip replacement (THR) in patients with renal transplants who developed femoral head avascular necrosis (AVN).
• To assess the efficacy and safety of THR for managing hip pain and dysfunction caused by AVN in this specific patient population.

Main Methods:

• Retrospective study of 138 renal transplant patients, identifying 19 (15%) with femoral head AVN.
• Detailed analysis of nine THR procedures in eight patients with AVN, all of whom had a history of systemic corticosteroid treatment.
• Radiographic assessment of femoral head collapse and clinical evaluation of pain and function.

Main Results:

• All eight patients experienced significant improvement in functional capacity and pain relief following THR.
• No major surgical complications were reported during the procedures.
• Radiographic evidence of femoral head collapse was present preoperatively in all studied patients.
• Follow-up averaging three years showed no signs of component loosening.

Conclusions:

• Total hip replacement (THR) is a safe and effective treatment for femoral head avascular necrosis (AVN) in renal transplant patients, particularly those with corticosteroid-induced AVN.
• THR can markedly improve pain and function, leading to better quality of life in this patient group.
• The procedure demonstrates good long-term implant stability without loosening in this cohort.