Osteonecrosis of the femoral head and condyle in the post transplantation courses of children and adolescents.

The clinical courses of 29 children and adolescents who received their first renal allografts at the University of Florida from 1973 to 1979 were reviewed for the development of osteonecrosis. A minimum follow-up period of 24 months with adequate allograft function was required for inclusion in the study. The incidence of post transplantation osteonecrosis was 21%. The presence of osteodystrophy prior to transplant was strongly correlated with osteonecrosis. Dialysis against high calcium baths prior to transplantation played a protective role. Extensive reviews of their records failed to clearly identify other predisposing factors. Osteonecrosis of the knee was treated with plaster immobilization and osteonecrosis of the femoral head by resection arthroplasty and angulation osteotomy. Improved functional results were obtained on the Iowa Hip Rating Scales.