Long-term results after resection arthroplasty according to Girdlestone for treatment of persisting infections of the hip joint

Introduction: Persisting infections of the hip joint are regarded as one of the most feared complications following total hip arthroplasty or failed o steosynthetic treatment of fractures of the proximal femoral part. In these cases resection arthroplasty according to Girdlestone often is the ultimat e treatment. Methods: Twenty-seven patients (11 men and 16 women) who had u ndergone resection arthroplasty according to Girdlestone could be included in this study. In all cases Girdlestone operations had been performed becau se of persisting infections of the hip joint. The mean follow-up was 7.1 ye ars. Results: In 22 out of 27 cases (81.5 %) er-radication of the infection was finally achieved. At the time of re-evaluation 6 patients had no pain, 12 sometimes suffered from moderate pain, 7 from pain during physical acti vities and 2 patients experienced pain even at rest. At the time of follow- up, 11 patients used a cane, 14 patients needed two canes or crutches and i n 2 cases a wheelchair was necessary. The mean shortening of the leg was 5. 2 cm (range 3-15 cm). Clinical evaluation using the score according to Merl e d'Aubigne and Postel to assess the functional results showed a mean of 6. 7 points (range 2-10 points). Of our patients, 59.3 % were satisfied with t he functional results obtained. Conclusion: In the long run the Girdlestone procedure still seems to be a reasonable salvage operation for persisting deep infections following hip surgery.