Excision arthroplasty for infected total hip replacements

Abstract

A study of excision arthroplasty (Girdlestone's pseudarthrosis) for infected total hip replacements is presented. Twenty-two patients were reviewed with a minimum follow-up of one year. Reduction in pain was significant but the functional results were poor. Factors contributing to poor function were old age, poor medical condition and arthritis of the contralateral hip; these were in addition to the gross instability resulting from the pseudarthrosis. The patients were easily fatigued and dependent on external supports; calipers were found to be unacceptable. The symptoms after excision arthroplasty are compared with those before the original hip replacement.

Structural Allograft as an Option for Treating Infected Hip Arthroplasty with Massive Bone Loss

“…Treatment options are few. Excision arthroplasty eradicates infection in 86% to 100% of patients [26,29] and relieves pain in 30% to 59% of patients [26,29], but it functionally impairs the patient with major leg length discrepancy and poor walking ability [5,6,15]. It is now reserved as a salvage technique.…”

Girdlestone resection arthroplasty following failed surgical procedures

“…Patients with severe loss of bone stock, risk of recurrent infection or poor general condition [2,4,9,11] may not be suited for further major interventions, especially one-or two-stage reimplantation after failed primary total hip replacement. In such cases, Girdlestone resection arthroplasty is considered to be an acceptable option.…”

The Girdlestone pseudarthrosis in the treatment of infected hip replacements

“…Satisfactory results have been reported with relief of pain and restoration of function [22], but poor functional results have been described [1,7,17]. Control of infection has, however, been reported in from 76% to 92% of cases [2,7,12,19].…”