J Korean Orthop Assoc.  2007 Feb;42(1):45-52. 10.4055/jkoa.2007.42.1.45.

The Early Results of a Cementless Total Hip Arthroplasty in Femoral Head Necrosis in Renal Transplant Recipients

• Lee JH
• Cho SG
• Yoon TR
• Park SJ
• Song EK
• Seon JK

• KMID: 2106374
• DOI: http://doi.org/10.4055/jkoa.2007.42.1.45

Abstract

Purpose: To analyze the clinical results of cementless total hip arthroplasty (THA) for the treatment for osteonecrosis of the femoral head in renal transplant recipients.
Materials and Methods
Twenty-one cementless THA were performed in 15 renal transplant recipients with advanced osteonecrosis of the hip. The average interval from the transplant to arthroplasty was 43 months (range, 7-122 months). The mean age at the time of arthroplasty was 35 years (range, 25-58 years). The average preoperative Harris hip score was 40 points (range, 31-57 points). The mean follow-up period was 45 months (range, 24-101 months).The articulations were metal-on-polyethylene bearing in 1 case, metal-on-metal in 6 cases, and ceramic-on ceramic in 14 cases.
Results
The average postoperative Harris hip score was 91 points (range, 82-94 points), and there were no problems such as wound healing or infections despite the immunosuppressed state. Radiographically, there was one case of femoral and acetabular osteolysis, which had used metal on polyethylene articulation, 80 months after surgery. There was neither aseptic loosening nor dislocation after an average 45 months. Heterotopic ossification was detected in 1 case.
Conclusion
The early results of a cementless THA in this young group of renal transplant recipients is encouraging.

Keyword

Hip; Osteonecrosis; Total hip arthroplasty; Renal transplantation

MeSH Terms

Acetabulum
Arthroplasty
Arthroplasty, Replacement, Hip*
Ceramics
Dislocations
Follow-Up Studies
Head*
Hip
Kidney Transplantation
Necrosis*
Ossification, Heterotopic
Osteolysis
Osteonecrosis
Polyethylene
Transplantation*
Wound Healing
Ceramics
Polyethylene

Figure

• 

  Fig. 1 (A) Immediate postoperative radiograph of a 32 year old man who had a cementless metal on polyethylene THA is showed. (B) Postoperative 80 months radiograph shows osteolysis in Gruen zone I in the femoral side and DeLee and Charnley zone I in the acetabular side.

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