Karapinar Levent, Gurkan Alp, Kacar Serdar, Polat Omer
Department of Orthopedics and Traumatology, Izmir-Tepecik Training and Research Hospital, Izmir, Turkey.
Ann Transplant. 2007;12(4):27-31.
We investigated the presence of femoral head avascular osteonecrosis (FHAVN) by a selective investigation with MRI at follow-up.
MATERIAL/METHODS: A total of 331(200 men, 131 women) renal transplants were included. They were transplanted at the mean age of 31.4 (9-63) years. The mean follow-up time of all patients after transplantation was 60.6 (6-233) months, and the mean current age 36.6 (11-66) years. All transplants filled out a questionnaire on musculoskeletal symptoms and underwent a detailed clinical examination. Magnetic resonance imaging was done in cases of hip joint pain in groin, buttock, thigh and knee and in 50 asymptomatic transplants. FHAVN were identified according to Ficat Arlet classification.
43(13%) patients reported pain without previous trauma. In the clinical examination, limited ranges of motion of the hip were noted in 13 of them. FHAVN was detected in 11 of 43 patients. Disease was bilateral in two of the eleven patients. Of the 662 femoral heads, 43 were associated with hip pain whereas the remaining 619 were asymptomatic. Avascular osteonecrosis was not confirmed in the asymptomatic 100 hips with magnetic resonance imaging.
A selective investigation of FHAVN may be used to diagnose in renal allograft recipients with painful hips at follow-up. With a retrospective selective analysis, the presence of FHAVN was low among renal transplantation recipients at the end of the study.
我们在随访时通过MRI选择性检查来研究股骨头缺血性坏死（FHAVN）的存在情况。
材料/方法：共纳入331例肾移植患者（200例男性，131例女性）。他们的平均移植年龄为31.4岁（9 - 63岁）。所有患者移植后的平均随访时间为60.6个月（6 - 233个月），当前平均年龄为36.6岁（11 - 66岁）。所有移植患者均填写了一份关于肌肉骨骼症状的问卷，并接受了详细的临床检查。对于腹股沟、臀部、大腿和膝盖出现髋关节疼痛的患者以及50例无症状的移植患者进行了磁共振成像检查。根据菲卡特·阿莱特分类法确定FHAVN。
43例（13%）患者报告有疼痛但无既往创伤史。在临床检查中，其中13例患者髋关节活动范围受限。43例患者中有11例检测到FHAVN。11例患者中有2例为双侧患病。在662个股骨头中，43个与髋关节疼痛相关，其余619个无症状。磁共振成像检查未在无症状的100个髋关节中证实存在缺血性坏死。
对于随访时出现髋关节疼痛的肾移植受者，可采用对FHAVN的选择性检查来进行诊断。通过回顾性选择性分析，在研究结束时肾移植受者中FHAVN的发生率较低。
