Uncemented total hip arthroplasty in chronic hemodialysis patients

BACKGROUND AND PURPOSE Whether or not uncemented total hip arthroplasty (THA) can achieve durable fixation of implants to bone in patients on chronic hemodialysis is unknown. We analyzed the 2-13-year clinical outcomes of cementless THA in patients with end-stage renal diseases who were maintained on long-term hemodialysis. PATIENTS AND METHODS We reviewed the outcome of 23 consecutive uncemented THAs undertaken between 1993 and 2004, in patients with chronic renal failure who had been on long-term hemodialysis (2-18 years). 1 patient died and 2 patients were lost to follow-up within 2 years, leaving 20 hips (20 patients, median age 66 (38-81) years at the time of THA, 11 females) that were reviewed at median 7 (2-13) years postoperatively. RESULTS Radiographic bone-ingrowth fixation of the components was found in 19 patients. 1 patient had aseptic loosening requiring revision surgery. The median d'Aubigne and Postel score was 10 (8-14) preoperatively and 15 (12-18) at final review. No prosthetic infections were found in any of the patients. INTERPRETATION Uncemented THA shows promising medium-term results in patients receiving long-term hemodialysis.