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The Girdlestone pseudarthrosis in the treatment of infected hip replacements
J Castellanos1, X Flores, M Llusà
1Department of Orthopaedic Surgery and Traumatology, Rehabilitation and Traumatology University Hospital, Vall d'Hebron, Barcelona, Spain.
Abstract:
The results of 78 resections of the head and neck of the femur (Girdlestone pseudarthrosis) in patients with infected hip replacements were studied. The mean follow-up was 5 years. At the time of the resection, gram-positive organisms were found in 53% of the cases, gram-negative in 33%, and in 12% there were mixed flora. The Girdlestone pseudarthrosis controlled the infection in 86% and achieved satisfactory relief of pain in 83%. The mean shortening of the limb was 4.1 cm and every patient needed some type of external walking aid. We found no correlation between the type of organisms and the persistence of infection, nor between shortening and the functional results. The Girdlestone pseudarthrosis is an acceptable method of controlling infection and relieving pain after infection of a total hip replacement.
Insights
The Girdlestone pseudarthrosis procedure effectively controls infection in 86% of patients with infected hip replacements. This surgery provides pain relief for 83% but results in limb shortening, requiring walking aids.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Management
Background:
- Infected hip replacements pose significant challenges.
- The Girdlestone pseudarthrosis is a salvage procedure for severe hip joint infections.
Purpose of the Study:
- To evaluate the efficacy of Girdlestone pseudarthrosis in managing infected hip replacements.
- To assess infection control, pain relief, and functional outcomes.
Main Methods:
- Retrospective analysis of 78 Girdlestone pseudarthrosis procedures.
- Mean follow-up of 5 years.
- Microbiological analysis of surgical samples.
Main Results:
- Infection controlled in 86% of cases.
- Satisfactory pain relief achieved in 83%.
- Mean limb shortening of 4.1 cm; all patients required walking aids.
Conclusions:
- Girdlestone pseudarthrosis is an acceptable treatment for controlling infection after total hip replacement failure.
- The procedure offers significant pain relief despite functional limitations.
- No correlation found between microbial type and infection persistence or functional outcomes.