ABSTRACT
The considerable risks of osteonecroses and fractures after renal transplantation are well described. Whether or not these transplantation risks are unique to those with renal failure is uncertain. A 56-year-old man developed multiple spontaneous fractures, including a fracture of the femoral neck, following cardiac transplantation.
Subject(s)
Femoral Neck Fractures/etiology , Fractures, Spontaneous/etiology , Heart Transplantation , Bone Nails , Femoral Neck Fractures/diagnostic imaging , Femoral Neck Fractures/surgery , Fractures, Bone/diagnostic imaging , Humans , Immunosuppressive Agents/adverse effects , Lumbar Vertebrae/diagnostic imaging , Male , Middle Aged , Postoperative Complications/etiology , RadiographyABSTRACT
The use of arthrodesis to salvage failed total knee arthroplasty is reviewed in nine patients. Prosthetic failure was due to infection in six cases, aseptic loosening in two cases, and instability in one case. The techniques of arthrodesis included six Hoffman external fixators, two fluted intramedullary rods (3M-Orthopedic Products Division, St Paul), and one pulsing electromagnetic field stimulator. Arthrodesis was successful in eight of nine patients, averaging 5.4 months to union. All eight patients resumed a painfree functional level of activity. Meticulous surgical technique and appropriate method of arthrodesis are emphasized.
Subject(s)
Arthrodesis/methods , Knee Prosthesis/adverse effects , Aged , Arthritis, Rheumatoid/surgery , Humans , Joint Instability/complications , Knee Joint/diagnostic imaging , Male , Middle Aged , Osteoarthritis/surgery , Radiography , Reoperation , Surgical Wound Infection/complicationsABSTRACT
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.