Arfi S, Moreau F, Heuclin C, Kreis H, Paolaggi J B, Auguier L
Rev Rhum Mal Osteoartic. 1975 Mar;42(3):162-76.
Over a period of observation of 14 years, one or more aspetic osteonecroses (AON) were discovered in 29 patients who had undergone renal transplantation. Altogether 64 AON were discovered. In patients who had survived at least 1 year, the frequency of this lesion was 18 percent. These transplantation necroses were often bilateral (16 cases out of 21 AON of the femoral head) or multiple (6 patients presenting AON in more than 3 sites) ; necroses were sometimes found in unusual sites (shoulder, ankle, upper end of the tibia, scaphoid, condyle of the humerus). The AONs of the lower limbs were remarkable because of their extent and because of the rapid evolution of the radiological signs. This is in contrast to the moderate nature of the pain. Latent types of necrosis are also found (3 cases of AON of the femoral head). During a search for factors favouring the development of AON, the authors noted that the average duration of haemodialysis was longer in the patients with AON than in a control group of transplant patients. The average daily dose of corticoids for the first six months after transplantation was not significantly different in the two groups studied. However, the 15 patients with transplants who were not given corticoids did not develop AON.
在14年的观察期内，29例接受肾移植的患者中发现了一例或多例无菌性骨坏死（AON）。共发现64处AON。在存活至少1年的患者中，这种病变的发生率为18%。这些移植相关性坏死通常为双侧性（21例股骨头AON中有16例）或多发性（6例患者的AON出现在3个以上部位）；坏死有时出现在不寻常的部位（肩部、踝关节、胫骨上端、舟状骨、肱骨髁）。下肢的AON因其范围和放射学征象的快速演变而引人注目。这与疼痛的中度性质形成对比。还发现了潜伏性坏死类型（3例股骨头AON）。在寻找有利于AON发生发展的因素时，作者注意到，发生AON的患者血液透析的平均持续时间比移植患者对照组更长。两组研究对象移植后前六个月皮质类固醇的平均每日剂量无显著差异。然而，15例未使用皮质类固醇的移植患者未发生AON。
