Introduction: Excisional hip arthroplasty, or femoral head ostectomy, was first described by the English orthopedist Gathorne Girdlestone in 1928 and bears his name. The procedure involves removing the head and neck of the femur. Nowadays, a rather extended variant is usually performed, since, in addition to the classical removal of the head and neck, resection, fenestration, sequestrectomy in the proximal part of the femur is often required. In such cases, it is more correct to speak of a suspended hip joint. Surgery is used as a last resort and often a life-saving procedure in cases of severe, including periprosthetic, infections in the hip joint area.
Aim: An attempt is made to answer the question: Does Girdlestone surgery (suspended hip joint) have a place in the modern treatment of severe infections, including periprosthetic ones in the area of the hip joint?
Patients and Methods: Four patients are presented—3 women and 1 man, aged 45 to 74 years.
Result: A meticulously performed debridement, including excision of the contaminated soft tissues and bony areas, with a removal of the existing endoprosthesis, combined with a closed permanent irrigation system, proved to be the only effective and life-saving procedure for the presented patients.
Conclusion: Despite the listed disadvantages, the Girdlestone operation (suspended hip joint), in which the contaminated tissues and all foreign bodies are removed, often combined with a closed permanent irrigation system, has not lost its relevance, since in most cases it leads to complete sanitation of infection, is often a life-saving procedure or an important stage for subsequent repeat endoprosthetics.
Cornelis M Vincenten, Brenda L Den Oudsten, Pieter K Bos, Stefan B T Bolder, Taco Gosens. Quality of life and health status after Girdlestone resection arthroplasty in patients with an infected total hip prosthesisJ Bone Jt Infect . 2019 Jan 1;4(1):10-15. doi: 10.7150/jbji.28390.
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Vincenten CM, Den Oudsten BL, Bos PK, Bolder SB, Gosens T (2019) Quality of life and health status after Girdlestone resection arthroplasty in patients with an infected total hip prosthesis. J Bone Jt Infect 4: 10-15.
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