[Long-term results after resection arthroplasty according to Girdlestone for treatment of persisting infections of the hip joint].

INTRODUCTION

Persisting infections of the hip joint are regarded as one of the most feared complications following total hip arthroplasty or failed osteosynthetic treatment of fractures of the proximal femoral part. In these cases resection arthroplasty according to Girdlestone often is the ultimate treatment.

METHODS

Twenty-seven patients (11 men and 16 women) who had undergone resection arthroplasty according to Girdlestone could be included in this study. In all cases Girdlestone operations had been performed because of persisting infections of the hip joint. The mean follow-up was 7.1 years.

RESULTS

In 22 out of 27 cases (81.5%) eradication of the infection was finally achieved. At the time of re-evaluation 6 patients had no pain, 12 sometimes suffered from moderate pain, 7 from pain during physical activities and 2 patients experienced pain even at rest. At the time of follow-up, 11 patients used a cane, 14 patients needed two canes or crutches and in 2 cases a wheelchair was necessary. The mean shortening of the leg was 5.2 cm (range 3-15 cm). Clinical evaluation using the score according to Merle d'Aubigné and Postel to assess the functional results showed a mean of 6.7 points (range 2-10 points). Of our patients, 59.3 % were satisfied with the functional results obtained.

CONCLUSION

In the long run the Girdlestone procedure still seems to be a reasonable salvage operation for persisting deep infections following hip surgery.