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International Orthopaedics

, Volume 29, Issue 2, pp 92–95 | Cite as

Girdlestone resection arthroplasty following failed surgical procedures

  • H. SharmaEmail author
  • J. De Leeuw
  • D. I. Rowley
Original Paper

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.

Keywords

Femoral Neck Fracture Aseptic Loosening District General Hospital Poor General Health Death Interval 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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.

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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  1. 1.Department of Trauma and OrthopaedicsVictoria InfirmaryGlasgowUK
  2. 2.Department of Trauma and OrthopaedicsFalkirk and District Royal InfirmaryFalkirkUK
  3. 3.Department of Trauma and OrthopaedicsNinewells Hospital and Medical SchoolDundeeUK
  4. 4.GlasgowUK

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