Total hip replacement in a heart transplant recipient with multiple comorbidities: a case report

Background. According to available literature, recipients of solid organ transplants have a progressively increased risk of developing aseptic necrosis and osteoarthritis due to long-term corticosteroid and immunosuppressive therapy. Approximately 5% of transplant recipients develop femoral head avascular necrosis (FHAN). In such cases, the gold standard of treatment is total hip replacement (THR). However, this approach carries a high risk of postoperative infectious complications. Clinical case. A patient was admitted in Moscow at the City Center for Bone and Joint Endoprosthetics, Botkin Hospital for a planned THR. Six years earlier, she had undergone a heart transplant. Her clinical profi le was further complicated by multiple comorbidities, placing her in a highrisk category for perioperative complications according to the ASA classifi cation. Conclusion . Despite the high intraoperative and postoperative risks, THR was the only viable option to improve the patient’s quality of life, given the progression of FHAN.