[Osteonecrosis of the femur head in patients with renal transplant. Apropos of 82 surgically treated hips].

Fifty-six renal transplanted patients having an average age of 33 years have been operated on for necrosis of the femoral head from 1973 to 1988. They totalise 85 cephalic necrosis due to the therapeutic peaks of corticotherapy. The femoral condyles were affected by the necrosis in 21 patients, and the humeral head in 16 patients. 82 surgical operations of first intention and 18 resumptions leading to 100 the total number of operations. The 26 drilling gave place to 11 by arthroplasty. The good results of the drillings only concern the infraradiological stages and the MRI allows to detect the non symptomatic stages 0. The 33 intermediate prosthesis did not lead to septic complications but 9 cotiloidal alterations of which 4 important with a resumption by total prosthesis. 36 total prosthesis were realized out of which 13 for resumption. Two early and two late suppurations after septicemia complicated the evolution. If at stage 0 or 1 the drilling seems to remain a reliable indication, the total prosthesis is the only possible solution for invalidating stages IV, the intermediate prosthesis seems to be able to keep a place in the intermediate stages.