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 +/- 7 per cent (mean and two standard errors of the mean, 95 per cent confidence interval) at five years and 78 +/- 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 +/- 18 per cent and 72 +/- 30 per cent at five and ten years, respectively, compared with 92 +/- 7 per cent and 80 +/- 12 per cent for the patients who were less than forty years old. The acetabular components had a 94 +/- 6 per cent rate of survival at five years and an 86 +/- 9 per cent rate at ten years. The femoral components had a 97 +/- 4 per cent rate at five years and an 87 +/- 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.(ABSTRACT TRUNCATED AT 250 WORDS)