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Total hip replacement in renal transplant patients
S Deo1, C L Gibbons, M Emerton
1Nuffield Department of Orthopaedic Surgery, Nuffield Orthopaedic Centre, Headington, Oxford, UK.
The Journal of Bone and Joint Surgery. British Volume
|March 1, 1995
Summary
Total hip replacement (THR) effectively manages hip pain from osteonecrosis in renal transplant patients. However, THR in this population shows increased complication rates and lower survival compared to general populations.
Area of Science:
- Orthopedic Surgery
- Nephrology
- Transplantation Medicine
Background:
- Osteonecrosis of the hip is a known complication in renal transplant recipients.
- Painful osteonecrosis necessitates surgical intervention, such as total hip replacement (THR).
Purpose of the Study:
- To evaluate the outcomes and complications of total hip replacement (THR) in patients who have undergone renal transplantation.
- To assess the long-term survival and complication rates of THR in this specific patient cohort.
Main Methods:
- Retrospective analysis of 34 primary total hip replacements (THR) in 25 renal transplant recipients.
- Data collection included time from symptom onset to THR, time from transplantation to THR, follow-up duration, pain relief, and complications.
Main Results:
- All patients experienced pain relief following THR.
- Eight major complications were reported, including graft-related issues, deep infection, aseptic loosening, and pulmonary embolism.
- Survival analysis indicated a lower survival rate for THR in renal transplant recipients compared to general populations, with aseptic loosening being a common cause for revision.
Conclusions:
- Total hip replacement (THR) is the preferred treatment for painful hip osteonecrosis post-renal transplant.
- Renal transplant recipients undergoing THR face higher rates of both early and late complications.
- Close collaboration between orthopedic surgeons and renal transplant units is crucial for optimal patient management.