April 11, 2024

Girdlestone Arthroplasty of Hip Joint is the Salvage Procedure with the removal of femoral and acetabular components

Girldestone (1950)

Girdlestone Arthroplasty of Hip Joint
Girdlestone Arthroplasty of Hip Joint

Excision of the femoral head, neck, proximal part of the trochanter, and the acetabulum rim for deep-seated chronic infection of the hip joint

Then advised loose packing of the raw area (Left after excision ) by petroleum gauge and emphasized postoperative prevention of proximal displacement of the femur by application of plaster cast/ traction

Surgical Procedure for Girdlestone Arthroplasty of Hip Joint

Expose hip joint with anterolateral/ anterior-transverse incision

Incise capsule and ligament

Attempt to dislocate head

If not dislocated due to ankylosis:

  • Divide the femoral head and acetabular rim flush with the outer surface of the ilium
  • Divide the femoral neck at its base a little proximal and parallel to the IT line
  • Remove femoral head and neck with a 2-4 cm gap and no bone is left is depth

If the dislocation is possible

  • Excise femoral head and neck
  • The line of the base section is kept parallel to and a little proximal to the IT line

The raw surface of bone cauterize with electric diathermy

Antibiotics installed locally and wound closed in layer with low suction drainage

Skeletal traction was applied in the Upper tibia

Postoperatively

30-50 degrees of abduction maintained for 3 months

During the period of traction active and assisted movement of the hip encouraged

After 3 months of traction

  • Encouraged to walk with weight relieving orthosis/ crutches (6-9 months)

Then with a walking stick (Contralateral hand)

Some degree of shortening/ instability is present

Painfree motion is present

Walking and standing tolerance may vary

Some degree of telescoping of limb and tendency towards external rotation is common

See also: Tuberculosis of the Hip Joint

See also: Sir John Charnley

See also: Complication following THA