Abstract
We retrospectively reviewed 8 patients receiving hemodialysis for chronic renal failure, who underwent femoral head prosthetic replacement or total hip replacement.
We performed 7 femoral head prosthetic replacements in 6 patients and 3 total hip replacements in 2 patients between August 1988 and December 1996. The initial diagnoses were femoral neck fracture in 7 hips, aseptic necrosis of femoral head in 1 hip and osteoarthritis in 2 hips. Patients were 3 males and 5 females with mean age of 67.4 years, a mean duration of hemodialysis of 110.6 months. The underlying renal diseases in 8 patients included 6 cases of chronic glomerulonphritis, and one each of diabetic nephropathy and polycystic kidney. The mean follow-up period was 38.1 months.
Surgery was performed under general or lumbar anesthesia. Mean surgical duration, mean bloodloss and mean volume of blood transfusion were 108.7 min., 710.4ml and 580ml, respectively. Two arthroplasties in one patient failed due to dislocation, but there was no sign of infection in any patient. Of the 7 speciemens available for histopatholoical examination, amyloid, aluminum and iron depositions were detected in 6 cases.
Our experience in these clinical cases suggests that femoral head prosthetic replacement or total hip replacement should be performed carefully in hemodialysis patients. To prevent renal osteodystrophy and hemodialysis-associated amyloidosis, it is also important to avoid the aluminum, iron and amyloid deposition as complications in patients on long-term hemodialysis.
