Quality of life and health status after Girdlestone resection arthroplasty in patients with an infected total hip prosthesis

Abstract

Introduction: The Girdlestone resection arthroplasty (GRA) is a salvage procedure for a recurrent or persistent prosthetic joint infection of the hip. This procedure negatively impacts the functional outcome and presumably also diminishes health status (HS) and quality of life (QOL). However, studies investigating the QOL after GRA are lacking. This cross-sectional study compares patients with a Girdlestone situation after an infected total hip prosthesis with a normative population with regard to HS and QOL.Methods: Patients with a permanent GRA were suitable to be enrolled in the study. Subjects completed the World Health Organization Quality of life (WHOQOL-BREF) and the EuroQol 5 dimension 3 level version (EQ-5D-3L). Scores were compared with data from the normal population, from patients with a lower limb amputations and data from patients with a myocardial infarction.Results: Sixty-three patients who underwent GRA between January 2000 and March 2017 completed the questionnaire. The median time between the GRA and competing the questionnaire was 48 months (4 -436). All WHOQOL-BREF domain scores were significantly lower in GRA patients compared to the normative data (p<0.001), patients with myocardial infarction or lower limb amputation. EQ-5D-3L results showed that HS was significantly impaired in GRA patients when compared to normative data (p<0.001) and also impaired when compared to data from lower limb amputations and myocardial infarctions.Conclusion: HS and QOL scores in patients with a permanent Girdlestone situation after an infected hip prosthesis are significantly lower than Dutch normative scores. Patients with a permanent Girdlestone situation scored even lower on HS than patients with a lower limb amputation or a myocardial infarction.

The Girdlestone situation: a historical essay

“…multiple comorbidities 9. Functional outcome and quality of life after GRA is often impaired due to limb shortening, pain, hip instability and an inevitable need for a walking aid 10, 11.…”

“…Currently the average age for performing Girdlestone resection arthroplasty is 72 years 10. This relatively high age correlates with the average age of primary total hip arthroplasty, which is now 70-72 12.…”

Is there a role for the Girdlestone resection arthroplasty in modern orthopedic trauma surgery? Case series from a medically underserved region and literature review

“…The indications in the literature for GRA were hip joint infections. Especially in more recent publications, infections following THA were the main indication for GRA [7][8][9][10].…”

Analysis of Failed Two-Stage Procedures with Resection Arthroplasty as the First Stage in Periprosthetic Hip Joint Infections

“…There are some limitations in this study such as the retrospective nature of the study design with all its disadvantages and the short follow-up time. Additionally, the study did not include an evaluation of functional outcome as it was discussed previously [ 43 , 44 , 45 ]. Other limitations are the restricted number of patients and dependence on medical records prepared by different clinicians during a period of 10 years.…”