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Fifty patients with osteonecrosis following a renal transplantation were managed with a total of seventy-six total hip arthroplasties with cement between 1972 and 1982 at the University of Minnesota. The minimum duration of follow-up was ten years.With use of Kaplan-Meier survivorship analysis, with revision for any reason as the end point, the over-all rate of survival of the implants in all patients was 91 plus/minus 7 per cent (mean and two standard errors of the mean, 95 per cent confidence interval) at five years and 78 plus/minus 11 per cent at ten years. The prostheses in the patients who were more than forty years old had a rate of survival of 87 plus/minus 18 per cent and 72 plus/minus 30 per cent at five and ten years, respectively, compared with 92 plus/minus 7 per cent and 80 plus/minus 12 per cent for the patients who were less than forty years old. The acetabular components had a 94 plus/minus 6 per cent rate of survival at five years and an 86 plus/minus 9 per cent rate at ten years. The femoral components had a 97 plus/minus 4 per cent rate at five years and an 87 plus/minus 9 per cent rate at ten years.We concluded that the results of total hip arthroplasty with cement after renal transplantation are satisfactory and are comparable with those for patients of similar age who have not had a renal transplantation.The rate of early or late infection related to the implant was low (one [1.3 per cent] of seventy-six hips) in these immunocompromised patients, and the rate of dislocation was relatively high (twelve [16 per cent] of seventy-six hips). The revision-free survival of the implants was longer than the life expectancy of patients who have a renal transplantation. Given the reduced life span of these patients, the results of total hip arthroplasty are more analogous to those in older patients who have not had a renal transplantation than those in younger patients who have not had such a transplantation.