Total hip arthroplasty in the cardiac transplant patient.

Osteonecrosis of the femoral head following cardiac transplantation has led to bilateral total hip arthroplasties in 2 patients. The clinical course and rejections of these patients are outlined. The pathological changes in the femoral heads suggested that the process leading to osteonecrosis in the cardiac transplant patient is the same as that following renal transplantation, both being due to immunosuppression probably related to steroid dosage. Successful joint replacement can be carried out in the cardiac transplant with careful monitoring of anesthesia. Both patients have done well, being followed for 14 and 6 months respectively.