title: Clinical outcome following conversion of Girdlestone's resection arthroplasty to total hip replacement: a retrospective matched case-control study.
abstract: A total of 31 patients, (20 women, 11 men; mean age 62.5 years old; 23 to 81), who underwent conversion of a Girdlestone resection-arthroplasty (RA) to a total hip replacement (THR) were compared with 93 patients, (60 women, 33 men; mean age 63.4 years old; 20 to 89), who had revision THR surgery for aseptic loosening in a retrospective matched case-control study. Age, gender and the extent of the pre-operative bone defect were similar in all patients. Mean follow-up was 9.3 years (5 to 18). Pre-operative function and range of movement were better in the control group (p = 0.01 and 0.003, respectively) and pre-operative leg length discrepancy (LLD) was greater in the RA group (p < 0.001). The post-operative clinical outcome was similar in both groups except for mean post-operative LLD, which was greater in the study group (p = 0.003). There was a significant interaction effect for LLD in the study group (p < 0.001). A two-way analysis of variance showed that clinical outcome depended on patient age (patients older than 70 years old had worse pre-operative pain, p = 0.017) or bone defect (patients with a large acetabular bone defect had higher LLD, p = 0.006, worse post-operative function p = 0.009 and range of movement, p = 0.005), irrespective of the group. Despite major acetabular and femoral bone defects requiring complex surgical reconstruction techniques, THR after RA shows a clinical outcome similar to those obtained in aseptic revision surgery for hips with similar sized bone defects.
authors.affiliation: Department of Biostatistics, Hospital Universitario La Paz- Idi Paz, Castellana 261, 28046 Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Garcia-Rey
authors.affiliation: Department of Biostatistics, Hospital Universitario La Paz- Idi Paz, Castellana 261, 28046 Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Cruz-Pardos
authors.affiliation: Department of Biostatistics, Hospital Universitario La Paz- Idi Paz, Castellana 261, 28046 Madrid, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Madero
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D005269:Femur / Q000601:surgery*; D005544:Forecasting; D006622:Hip Prosthesis; D006801:Humans; D007870:Leg Length Inequality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Case-control; Girldestone; Matched; Outcome; Resection-arthroplasty; Revision total hip replacement