Avascular necrosis and the blood supply of the femoral head.

Postmortem femoral artery perfusion revealed abnormalities in the femoral head pattern of vessels in steroid-treated renal transplant patients as compared with controls. Degenerative changes were found in some of the arteries and arterioles of the hip capsule and femoral head in the renal transplant patients. Two of these patients' femoral heads showed microfocal avascular necrosis. Although high-dose steroids were used in these patients, none had suffered clinically from hip disease while alive. These findings suggest the possibility that local arterial disease may be involved in the pathogenesis of avascular necrosis.