title: A six-year follow-up of infected total hip replacements managed by Girdlestone's arthroplasty.
abstract: Thirty-three Girdlestone's arthroplasties used to salvage infected total hip replacements were followed for a mean of 6.2 years to assess the efficacy of this procedure. Subjective and objective assessment was obtained at the time of review. Gram-negative organisms, retained cement, bony sequestra and secondary healing were common features of the five patients (15%) whose wounds discharged for more than four weeks after operation. Girdlestone's arthroplasty provided satisfactory pain relief in 91% of patients, and control of infection in 97%. Although leg-length discrepancy (mean 4 cm) and a Trendelenburg gait made walking difficult and tiring , 42% were satisfied with their functional ability; 85% needed walking aids, and 3 patients could not walk at all and were confined to bed or a chair. Overall, 79% were satisfied. Objectively, the mean Harris hip rating was 60; however, if patients with multiple joint problems were excluded, this score increased to 77. Girdlestone's arthroplasty seems a reasonable salvage procedure in the management of an infected total hip replacement and the results seem to improve with time.
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000209:etiology / Q000601:surgery*; D003258:Consumer Behavior; D005069:Evaluation Studies as Topic; D005260:Female; D005269:Femur / Q000601:surgery; D005500:Follow-Up Studies; D006621:Hip Joint / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007870:Leg Length Inequality; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery; D013530:Surgical Wound Infection / Q000209:etiology / Q000601:surgery*; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents