Girdlestone procedure is excision arthroplasty of hip in which femoral head, neck, proximal part of trochanter and the acetabular rim are removed. Modern technological advancements in revision hip arthroplasty have revolutionised the treatment of failed primary total hip replacements. The decision to. Girdlestone resection arthroplasty should be considered as a salvage procedure, primarily aimed at pain relief and infection control. Such patients must be.
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The patient was able to walk independently with the help of a stick, has mild pain on walking for more than a kilometer. The procedure was described for chronic deep-seated infections of the artnroplasty joint.
The standard posterior approach was used to expose the hip joint. This site uses Akismet to reduce spam. The results mentioned in the literature are not generally uniform.
Shoulder is proximal and elbow is distal. Due to his age 88 he is basically bedridden, however today I noted that the affected thigh is much larger than the normal leg and he experienced pain when I moved the leg. John Peel, We do follow Girdlestone procedure with skeletal traction.
This website is an effort to educate and support people and medical personnel on orthopedic issues and musculoskeletal health. Improper implantation in Hemiarthroplasty fails subsequently.
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girdlestkne My friend underwent a left hip Girdlestone aratroplasty with tendon releases in July Pradeep bhosle et al in arhroplasty series of 89 cases inwhere Total hip replacement was performed for failed hemiarthroplasty concluded that THR is an excellent option in failed hemiathroplasty cases [ aethroplasty ].
Except for shortening and unstable gait, no other handicap was observed; the disadvantages of this handicap were outweighed by its advantages, compared with the disadvantages of other sophisticated hip operations such as replacement, and mould arthroplasties or even total hip replacement.
The operation was performed for various conditions which included femoral neck fracture, rheumatoid arthritis, ankylosing spondylitis, tuberculosis, septic arthritis, unreduced posterior dislocation of long duration, fracture of the acetabulum, avascular necrosis of femoral head and bony ankylosis. The patient is encouraged to sit soon after the operation, and repetitive active assisted movements of the hip and knee are started during the first week.
In such situations total hip arthroplasty procedure, though technically challenging will give stable painless hip to the patient. Patient was walking with the support of a walking aid. Such patients may require hip stabilization procedures may be done 3 to 6 months after the Girdlestone operation.
Girdlestone Procedure or Excision Arthroplasty of Hip | Bone and Spine
Though good relief arthroplashy achievable in some cases from Girdle stone arthroplasty, in most cases the results are not satisfactory [ 456 ]. If so then forces that act on hip could result in the fracture especially when the hip is weak.
I am not saying it is an infection. Overall, Girdlestone arthroplasty provides an unstable pain-free hip. India Find articles by VJ Purushotham. A swelling should be examined and investigated. Get more stuff on Musculoskeltal Health Subscribe to our Newsletter and get latest publications on Musculoskeletal Health your email inbox. Though technically challenging, total hip arthroplasty in certain cases will give a relatively stable and painless hip, as is the observation in our case. A discussion with the doctor who is seeing him might help you further.
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Hem may take anytime between months to walk with support. The patient was thoroughly investigated to rule out any signs of underlying infection. Case report A 60 year old male patient presented to us in the outpatient department with complaints of limp and shortening of the right lower limb for the past one year. Meanwhile, you can have a discussion with your treating doctor. The trend of Girdlestone procedure is declining but it remains a valuable surgery in select cases. In old age and immunocompromised states such as diabetes, it is not always necessary to have systemic symptoms like fever etc.
In this case where the proximal femur was completely intact was ideal for conversion to total hip arthroplasty. The trial prosthesis was placed and reduction was attempted. Subscribe to our Newsletter and get latest publications on Musculoskeletal Health your email inbox.
The results of girdlestone hips vary from good to poor in the various studies published. For optimum results regimen of postoperative care is essential.
We do follow Girdlestone procedure with skeletal traction. He was not placed on a skeletal traction nor sent to rehab instead he was discharged 4 days later to come to his residential home. The procedure was developed by British surgeon Gathorne Girdlestone as a lifesaving measure to remove disease and devitalized tuberculous hips in the pre-antibiotic era.
An improperly implanted bipolar prosthesis creates more problems with one of the options being a Girdlestone arthroplasty. InPankaj A, Surya bhan et al in their series of 44 cases concluded that conversion of symptomatic hemiarthroplasty to total hip arthroplasty is a safe option that gives good functional results, with marginally higher rates of intra-operative complications [ 10 ].
The traction is kept for 3 months. Awaiting for your response. He presented to us in this situation, where we successfully converted the Girdlestone arthroplasty to a Total Hip arthroplasty. The mantle was drilled with 3. On October 5, he had a right hip fracture.
In view of its functional end results, we feel that this measure can be a good alternative to more modern and sophisticated hip operations in the form of partial or total hip replacement under Indian conditions.