Over an eight-year period (1990-1997), we performed total hip arthroplasty (THA) on four hip joints in three patients who had been undergoing dialysis. The duration of dialysis before operation averaged 16 years and the average age of the patients was 38.5 years. The average follow-up period was 9.8 years. We performed one cemented THA and three cementless THAs. Two hip joints resulted in loosening. One of them developed loosening in an early stage (2.5 years). The patient suffered from secondary hyperparathyroidism and bone brittleness. Parathyroidectomy was performed because conservative therapy was not effective. Revision THA was performed after hyperparathyroidism improved. The patient did well two to three years after the revision.
We know that there is a lower success rate for THA in patients of long-term dialysis than in the general population. In such cases, it is suggested that secondary hyperparathyroidism may cause THA loosening.
