Skip to main content
Log in

Girdlestone resection arthroplasty following failed surgical procedures

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

We retrospectively reviewed 43 patients who had undergone Girdlestone resection arthroplasty of the hip after failed total hip replacement or failed operations for hip trauma between 1990 and 2002. The indications were peri-prosthetic infection, aseptic loosening, recurrent dislocation and failed internal fixation for femoral neck fractures. Twenty-five patients died with an overall mortality of 58%. Out of 18 survivors, four patients had a prosthesis re-implanted and were excluded from the study. In 14 surviving patients followed-up for a mean of 44.5 months, the average age was 76 years. Adequate pain relief was achieved in 12 patients and infection was controlled in all. They all needed walking aids. The overall patient satisfaction was 10/14. We observed that patients who had had resection arthroplasty following failed operations for hip trauma had a higher mortality than those for failed total hip arthroplasty. Girdlestone arthroplasty is still a viable option to salvage irretrievably failed hips presenting technical difficulties in medically compromised patients. Limb shortening and the inevitable need for a walking aid should be clearly explained to patients during the consenting process in order to avoid unrealistic expectations.

Résumé

Nous avons examiné rétrospectivement 43 malades qui avaient subi une résection de la hanche (Girdlestone) après échec de prothèse totale ou d’intervention pour traumatisme entre 1990 et 2002. Les indications étaient l’infection périprothètique, le descellement aseptique, la luxation récidivante et l’échec de l’ostéosynthèse d’une fracture du col fémoral. Vingt-cinq malades sont morts, représentant une mortalité totale de 58%. Quatre malades avaient un ré-implantation secondaire de prothèse et ont été exclus de l’étude. Il y avaient 14 survivants d’âge moyen 76 ans, suivis en moyenne pendant 44.5 mois. Le soulagement de la douleur était obtenu pour 12 malades, l’infection était contrôlée dans tous les cas, et tous les malades utilisaient des aides à la marche. Dix malades sur 14 étaient satisfaits. Nous avons observé que les malades qui avaient eu la résection après échec d’ostéosynthèse avaient une plus haute mortalité qu’après échec d’arthroplastie totale. L’arthroplastie par résection de la hanche (Girdlestone) est encore une option utile pour sauver des hanches irréversiblement détériorées chez des malades techniquement difficile et médicalement compromis. Le raccourcissement du membre et le besoin constant de l’aide à la marche devrait être bien expliqué aux malades pendant l’information en vue du consentement, afin d’éviter des attentes indues.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ahlgren SA, Gudmundsson G, Bartholdsson E (1980) Function after removal of a septic total hip prosthesis. A survey of 27 Girdlestone hips. Acta Orthop Scand 51(3):541–545

    Google Scholar 

  2. Bittar ES, Petty W (1982) Girdlestone arthroplasty for infected total hip arthroplasty. Clin Ortop 170:83–87

    Google Scholar 

  3. Bohler M, Salzer M (1991) Girdlestone’s modified resection arthroplasty. Orthopedics 14(6):661–666

    Google Scholar 

  4. Bourne RB, Hunter GA, Rorabeck CH, Macnab JJ (1984) A six-year follow-up of infected total hip replacements managed by Girdlestone’s arthroplasty. J Bone Joint Surg Br 66(3):340–343

    Google Scholar 

  5. Campbell A, Fitzgerald B, Fisher WD, Hamblen DL (1978) Girdlestone pseudarthrosis for failed total hip replacement. J Bone Joint Surg Br 60:441–442

    Google Scholar 

  6. Castellanos J, Flores X, Llusa M, Chiriboga C, Navarro A (1998) The Girdlestone pseudarthrosis in the treatment of infected hip replacements. Int Orthop 22(3):178–181

    Google Scholar 

  7. Clegg J (1977) The results of the pseudarthrosis after removal of an infected total hip prosthesis. J Bone Joint Surg Br 59(3):298–301

    Google Scholar 

  8. Esenwein SA, Robert K, Kollig E, Ambacher T, Kutscha-Lissberg F, Muhr G (2001) Long-term results after resection arthroplasty according to Girdlestone for treatment of persisting infections of the hip joint. Chirurg 72(11):1336–1343

    Article  Google Scholar 

  9. Grauer JD, Amstutz HC, O’Carroll PF, Dorey FJ (1989) Resection arthroplasty of the hip. J Bone Joint Surg Am 71(5):669–678

    Google Scholar 

  10. Mallory TH (1978) Excision arthroplasty with delayed wound closure for the infected total hip replacement. Clin Ortop 137:106–111

    Google Scholar 

  11. McElwaine JP, Colville J (1984) Excision arthroplasty for infected total hip replacements. J Bone Joint Surg Br 66(2):168–171

    Google Scholar 

  12. Muller RT, Schlegel KF, Konermann H (1989) Long-term results of the Girdlestone hip. Arch Orthop Trauma Surg 108(6):359–362

    Article  Google Scholar 

  13. Petty W, Goldsmith S (1980) Resection arthroplasty following infected total hip arthroplasty. J Bone Joint Surg Am 62(6):889–896

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to H. Sharma.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sharma, H., De Leeuw, J. & Rowley, D.I. Girdlestone resection arthroplasty following failed surgical procedures. International Orthopaedics (SICOT) 29, 92–95 (2005). https://doi.org/10.1007/s00264-004-0633-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-004-0633-3

Keywords

Navigation