Author/Editor		Dolinar, D; Pavlovčič, V; Kaplan-Pavlovčič, S; Milčinski, M; Jevtič, V; Sedonja, I
Title		Femoral head necrosis following renal transplantation treated by core decompression
Type		članek
Source		In: Buturović-Ponikvar J, Bren AF, editors. Zbornik 2. slovenski nefrološki kongres z mednarodno udeležbo ob 30. letnici dialize in transplantacije ledvic v Sloveniji; 2000 sep 27-30; Brdo pri Kranju. Ljubljana: Klinični center, Klinični oddelek za nefrologijo,
Publication year		2000
Volume		str. 49-53
Language		eng
Abstract		Femoral head necrosis is a common complication in renal transplant recipients. Despite the young age of these patients, replacement arthroplasty is often used in treating symptomatic individuals. Our recent prospective study compared the diagnostic accuracy of individual noninvasive investigations in diagnosing early avscular necrosis and evaluated the results of core decompression performed in patients with the earliest stages (Steinberg I and II) of the femoral head necrosis following renal transplantation in order to delay the need for replacement arthroplasty. Since May 1998 we performed 6 core decompressions in four patients (two patients had bilateral decompression). There were 2 men and 2 women, aged 33-54 (average 40.3) years. The average interval from initial transplant to hip pain was 11.5 (range 1-36) months and the average duration of symtoms before operative treatment was 5 (range 3-7) months. For diagnosis and evaluation of the necrotic process we used MRI and pinhole scintigraphy (preoperatively and 1 year postoperatively). At the time of surgery all patients were treated with immunosuppressive therapy, which included steroids. After average follow up of 17 month, there is no evidence of progression of the disease in 3 hips. MRI and pinhole scintigraphy confirmed efficient revascularisation of the femoral heads. In remaining 3 cases the necrotic process continued with collapse of the femoral head after core decompression.
Descriptors		KIDNEY TRANSPLANTATION FEMUR HEAD NECROSIS DECOMPRESSION, SURGICAL TREATMENT OUTCOME