TOTAL HIP-ARTHROPLASTY WITH CEMENT AFTER RENAL-TRANSPLANTATION - LONG-TERM RESULTS

Fifty patients with osteonecrosis following a renal transplantation we re managed with a total of seventy-six total hip arthroplasties,vith c ement between 1972 and 1982 at the University of Minnesota, The minimu m duration of follow-up was ten years, With use of Kaplan-Meier surviv orship analysis, with revision for any reason as the end point, the ov er-all rate of survival of the implants in all patients was 91 +/- 7 p er cent (mean and two standard errors of the mean, 95 per cent confide nce interval) at five years and 78 +/- 11 per cent at ten years, The p rostheses in the patients who were more than forty years old had a rat e of survival of 87 +/- 18 per cent and 72 +/- 30 per cent at five and ten years, respectively, compared with 92 +/- 7 per cent and 80 +/- 1 2 per cent for the patients who were less than forty years old, The ac etabular components had a 94 +/- 6 per cent rate of survival at five y ears and an 86 +/- 9 per cent rate at ten years. The femoral component s had a 97 +/- 4 per cent rate at five years and an 87 +/- 9 per cent rate at ten years, We concluded that the results of total hip arthropl asty with cement after renal transplantation are satisfactory and are comparable with those for patients of similar age who have not had a r enal transplantation. The rate of early or late infection related to t he implant was low (one [1.3 per cent] of seventy-six hips) in these i mmunocompromised patients, and the rate of dislocation was relatively high (twelve [16 per cent] of seventy-six hips). The revision-free sur vival of the implants was longer than the life expectancy of patients who have a renal transplantation. Given the reduced life span of these patients, the results of total hip arthroplasty are more analogous to those in older patients who have not had a renal transplantation than those in younger patients who have not had such a transplantation.