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Resection arthroplasty of the hip.
J D Grauer1, H C Amstutz, P F O'Carroll
1Division of Orthopaedic Surgery, University of California, Los Angeles School of Medicine 90024-1749.
Summary
Girdlestone procedures effectively treat hip sepsis and alleviate pain, but offer limited improvements in walking and activity. Preserving the proximal femur is crucial for better outcomes and potential future hip replacement.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Management
Background:
- Resection arthroplasty (Girdlestone procedure) is a salvage surgery for complex hip conditions.
- Indications include post-total hip replacement complications and primary septic arthritis.
Purpose of the Study:
- To analyze the outcomes of Girdlestone procedures.
- To identify factors influencing patient recovery and function.
Main Methods:
- Retrospective analysis of 48 Girdlestone procedures in 43 patients.
- Indications: post-total hip replacement sepsis (33), aseptic loosening (10), primary septic arthritis (5).
Main Results:
- Sepsis eradication in 45/48 patients; pain relief was nearly universal.
- Minor improvements in walking ability and activity levels.
- Significant limb shortening (3-11 cm) required walking support for all patients.
- Poorer outcomes noted in women and patients with prior hip replacement sepsis.
- Better function observed when proximal femur was largely preserved.
Conclusions:
- Girdlestone procedures are effective for sepsis control and pain relief but have functional limitations.
- Patient demographics and prior surgical history impact outcomes.
- Maximizing proximal femur preservation is recommended for functional recovery and future hip revision possibilities.