Girdlestone procedure is excision arthroplasty of hip in which femoral head, neck, proximal part of trochanter and the acetabular rim are removed. Modern technological advancements in revision hip arthroplasty have revolutionised the treatment of failed primary total hip replacements. The decision to. Girdlestone resection arthroplasty should be considered as a salvage procedure, primarily aimed at pain relief and infection control. Such patients must be.

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Total Hip Arthroplasty in a Girdlestone Hip following a Failed Hemiarthroplasty

Later an MRI scan of the hip was also done to rule out any possible signs of infection. Except for shortening and unstable gait, no other handicap was observed; the disadvantages of this handicap were outweighed by its advantages, compared with the disadvantages of other sophisticated hip operations such as replacement, and mould arthroplasties or even total hip girdlextone.

Critical radiological analysis after Austin Moore hemiarthroplasty. Improper implantation in Hemiarthroplasty fails subsequently.

Subsequently he underwent Girdlestone arthroplasty which resulted in persistent painful hip. It provided a painless, mobile hip. Oheim et al in in their series of 27 cases opined Girdle stone arthroplasty is still an essential surgery though not functionally satisfactory [ 9 ]. Footnotes Conflict of Interest: Girdlestone procedure is excision arthroplasty of the hip in which femoral head, neck, Proximal Nearer to the trunk.

After that, walking with a walking stick is started. The hip joint aspiration under C-arm guidance was done to rule out any infective collection which turned out to be negative. Shoulder is proximal and elbow is distal.

The mean loss of length by this technique is 1. Excision of head and neck of the femur was found to be an excellent salvage procedure for infected hips especially yielding uniformly satisfactory results at all ages irrespective of the disease.


On the other hand conversion of a long standing Girdlestone hip to a Total hip though is a well documented procedure in the literature, it is generally done for septic hips. Due to his age 88 he is basically bedridden, however today I noted that the affected thigh is much larger than the normal leg and he experienced pain when I moved the leg. The immediate post-operative period was uneventful and he was made to walk with support on the 3rd day.

Will I be able to walk normally or will I still have a bad limp with pain. For optimum results regimen of postoperative care is essential. Intracapsular fracture neck of femur is one of the most common fragility fractures in the elderly.

An undisplaced split in the trochanter was stabilized using a steel cable. He is diabetic but I was wondering that after one year five months the healing process would have been over.

Total Hip Arthroplasty in a Girdlestone Hip following a Failed Hemiarthroplasty

Get more stuff on Musculoskeltal Health Subscribe to our Newsletter and get latest publications on Musculoskeletal Health your email inbox. The recent X-ray of the hip [ Fig 4 ] showed gross proximal migration of femur with osteoporotic greater trochanter and cement mantle without any signs of loosening.

Movement away from the central axis. J Orthop Case Rep. The trend of Girdlestone procedure is declining but it remains a valuable surgery in select cases.

However Bitter ES, Petty W in their series of 14 patients concluded that the functional results were not good following Girdlestone and the patient often needed further girflestone, like fusion or replacement depending on the age of the patients [ 4 ].

In such cases where Hemiarthroplasty has failed or subsequent Girdlestone hip arthroplasty has failed to give relief to patient, Total girdlestohe arthroplasty should be considered though it is technically demanding especially after 2 failed surgeries prior to it.

Nearer to the trunk. The patient is put on skeletal traction in 30 to 50 degrees of Abduction It is a movement in coronal plane.


Better results with total hip arthhroplasty in Girdlestone hips can be expected in cases where more bone on the proximal femur can be preserved [ 7 ]. The results mentioned in the literature are not generally uniform. A swelling should be examined and investigated. Microbiological culture, patient age, duration of Girdlestone arthroplasty and the number of preceding surgical procedures did not correlate with the functional outcome after conversion [ 12 ].

Active physiotherapy and exercises in traction help patients to develop good muscle power, the maximal range of hip movements. Nil Source of Support: Although Girdlestone hip arthroplasty is a useful surgery, it is generally reserved for multiple failed attempts at reconstruction of the hip, generally as a result of infection or for septic and tubercular hips.

Moreover, not all local infections have identifiable systemic features. John Peel, We do follow Girdlestone procedure with skeletal traction. Excision arthroplasty may rarely leave behind a very unstable hip joint.

In view of its functional end results, we feel arthropllasty this measure can be a good afthroplasty to more modern and sophisticated hip operations in the form of partial or total hip replacement under Indian conditions. Discussion Intracapsular fracture neck of femur is one of the most common fragility fractures in the elderly.

Girdlestone Procedure or Excision Arthroplasty of Hip

He did not fall or sustained any injuries. As the drugs become more effective and revision arthroplasty yielding better results, in cases of infected prosthesis antimicrobial, definitive excision arthroplasty has become a salvage operation. Any suggestions or ideas as to what could be happening?