Girdlestone Arthroplasty of Hip Joint is the Salvage Procedure with the removal of femoral and acetabular components
Girldestone (1950)
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
