What is the outcome after a Girdlestone resection arthroplasty following a hip fracture?

Abstract

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.