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The Journal of Bone and Joint Surgery, Vol 71, Issue 5 669-678, Copyright © 1989 by Journal of Bone and Joint Surgery, Inc
Resection arthroplasty of the hip
JD Grauer, HC Amstutz, PF O'Carroll and FJ Dorey
Division of Orthopaedic Surgery, University of California, Los Angeles School of Medicine 90024-1749.
The results of forty-eight resection arthroplasties (Girdlestone
procedures) in forty-three patients were analyzed. The indications were
sepsis after a total hip replacement (thirty-three procedures), aseptic
loosening of a total hip replacement (ten procedures), and primary septic
arthritis (five procedures). The resection arthroplasty effectively
eradicated the sepsis in all but three patients, who had a recurrence. Pain
was alleviated in nearly all of the patients, but the ability to walk and
the level of activity improved only slightly. Shortening of the limb ranged
from three to eleven centimeters, and all patients used a support for
walking. The six patients who had a bilateral procedure were able to walk
using double supports. With regard to relief of pain, walking, and
function, the results were significantly poorer in the women, particularly
the older ones. The results were also significantly inferior in the
patients who had had sepsis after a total hip replacement. Generally,
walking, function, and the level of activity were better when much of the
proximal end of the femur had been retained. Resection arthroplasty should
spare as much of the proximal end of the femur as possible if a future
replacement of the hip is contemplated.
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