de Laat E A, van der List J J, van Horn J R, Slooff T J
Institute of Orthopaedics, Nijmegen, The Netherlands.
Acta Orthop Belg. 1991;57(2):109-13.
In case of irreversible failed total hip replacement, a Girdlestone operation is sometimes the obvious solution: excision of cement and prosthesis without attempting a new hip replacement. Reasons for not implanting a new prosthesis are severe loss of bone stock, the risk of recurrent infection, or poor general condition. A clinical follow-up study was performed on 40 patients who underwent a Girdlestone hip procedure using the following criteria: pain, walking distance and the use of a walking support. The mean follow-up was 4.9 years. Postoperatively 33 of 40 patients had less pain compared with the situation before the operation. Sixteen patients walked more than 500 m, 13 patients walked 200-500 m and 11 patients walked less than 200 m, of whom 4 were wheelchair bound. The objective result was good in 40% of the patients, moderate in 42.5%, and bad in 17.5%. Subjectively 62.5% were satisfied. A Girdlestone arthroplasty after loosening of the hip prosthesis was a satisfying solution in most cases.
对于全髋关节置换不可逆失败的情况，吉尔德斯通手术有时是显而易见的解决方案：切除骨水泥和假体，不再尝试进行新的髋关节置换。不植入新假体的原因包括骨量严重丢失、反复感染的风险或全身状况不佳。对40例行吉尔德斯通髋关节手术的患者进行了一项临床随访研究，采用以下标准：疼痛、行走距离和行走辅助工具的使用。平均随访时间为4.9年。术后40例患者中有33例与术前相比疼痛减轻。16例患者行走超过500米，13例患者行走200 - 500米，11例患者行走少于200米，其中4例需依赖轮椅。客观结果为40%的患者良好，42.5%的患者中等，17.5%的患者较差。主观上62.5%的患者感到满意。髋关节假体松动后行吉尔德斯通关节成形术在大多数情况下是一个令人满意的解决方案。
