Shah Nikki, Parker Martyn J
Trauma and Orthopaedic Surgery Department, Peterborough City Hospital, Peterborough, UK.
Hip Int. 2023 Sep;33(5):948-951. doi: 10.1177/11207000221126135. Epub 2022 Oct 2.
Joint infections or the complications of hip surgery may necessitate a Girdlestone resection arthroplasty. This is often kept as a last resort for patients with significant co-morbidities or when other treatments have been ineffective. The aim of this study was to define the outcome after Girdlestone excision arthroplasty when undertaken as a primary or secondary procedure for a hip fracture.
This is a retrospective review of a prospectively collected database involving 36 patients who underwent a Girdlestone procedure over a 30-year period. It compares the outcome for the 19 patients who survived to 1 year with those of 38 matched hip fracture patients.
Pain persisted in most patients after the procedure and was universal in those patients who could walk. Most patients experienced a significant loss of independence and a reduction in mobility status: 12/19 (63.1%) of those who survived to 1 year were immobile and of the remainder, all needed a Zimmer frame to walk. Overall, 41.7% of patients had died within 1 year of undergoing the procedure.
This study concludes that Girdlestone resection arthroplasty after a hip fracture is associated with a high degree of morbidity and mortality and therefore, should only be used as a salvage procedure after all other surgical measures have been exhausted.
关节感染或髋关节手术并发症可能需要进行Girdlestone切除关节成形术。对于患有严重合并症的患者或其他治疗无效时，这通常作为最后的手段。本研究的目的是确定Girdlestone切除关节成形术作为髋部骨折的初次或二次手术的术后结果。
这是一项对前瞻性收集的数据库进行的回顾性研究，该数据库涉及30年间接受Girdlestone手术的36例患者。将19例存活1年的患者的结果与38例匹配的髋部骨折患者的结果进行比较。
术后大多数患者仍持续疼痛，且能行走的患者普遍存在疼痛。大多数患者经历了显著的独立性丧失和活动能力下降：存活至1年的患者中，12/19（63.1%）无法活动，其余患者均需要助行架才能行走。总体而言，41.7%的患者在接受该手术后1年内死亡。
本研究得出结论，髋部骨折后进行Girdlestone切除关节成形术会导致高度的发病率和死亡率，因此，只有在所有其他手术措施均已用尽时，才应将其作为挽救性手术使用。
