Orthopedic complications of solid-organ transplantation

Organ transplantation has undeniably increased the longevity and quality of life of patients with end-stage organ failure. It has, however, introduced the skeletal complications of (1) fragility fractures and decreased bone density due to pretransplant bone loss and immunosuppressive therapy, and (2) avascular necrosis leading to subchondral fracture and secondary osteoarthritis. This article reviews these two skeletal complications of solid-organ transplantation that lead to structural failure of bone and result in significant morbidity and reduced quality of life.