Total hip replacement in patients with renal transplants.

In a retrospective study of total hip replacement (THR) arthroplasty in patients with renal transplants, femoral head avascular necrosis (AVN) was found in 19 of 138 (15%) patients. Nine THRs in eight of these 19 patients (average age, 47 years) were studied. Preoperatively, all patients had hip pain due to AVN and a history of long-term treatment with systemic corticosteroids. Six of the eight patients had been treated with parenteral pulsed steroids on three occasions, and the other two patients on one occasion, for rejection episodes. All patients showed some degree of femoral head collapse roentgenographically. There were no major surgical complications. All patients had markedly improved functional capacities and relief of pain. With follow-up averaging three years, there has been no evidence of component loosening.