Girdlestone arthroplasty for infected total hip arthroplasty

Abstract

Results of a previous study of 21 patients who underwent conversion of infected total hip arthroplasties to Girdlestone resection arthroplasties suggested that Girdlestone resection arthroplasty provides a functionally poor salvage technique and is often painful. The present study was undertaken to assess further the salvage value of Girdlestone arthroplasties for the treatment of infected total hips. Fourteen additional cases were reviewed, summarizing the clinical experience of the past three years. These more recent data support the conclusion that resection arthroplasty provides a poor functional result when used as a salvage procedure following removal of infected total hip components. Of the 14 patients reviewed, only one obtained an acceptable functional result. The initial 21 patients studied were re-reviewed to obtain further follow-up data. The functional results obtained were essentially unchanged and are comparable with those from the series of 14 patients reviewed in this study. In some cases of infected total hip arthroplasty, resection arthroplasty is the best method of treatment available, but the results are often far from ideal. Direct or indirect prothesis exchange is an alternative in some cases. Total hip arthroplasty should not be recommended for the young patient who has one or two joint diseases and no limiting systemic factors, with the expectation that when the total hip fails, it can be converted to a resection arthroplasty and the patient improved as compared with the pre-total hip status. It may be wiser to utilize another procedure, e.g., fusion, resection arthroplasty, or osteotomy, primarily, and then revise to a total hip, if necessary, when the patient is older.