Evaluation of girdlestone operation as treatment option for avascular necrosis of femoral head
Ameer Mohammad Muslem, Mohammed Naser Hussein, Abdulkareem Qasim Hussein
This is a prospective and retrospective study which was conducted in AL-Basrah General Hospital and Ibn- AL-Baitar Private Hospital from January 2009 to September 2010 (retrospectively we review cases in which Girdlestone procedure was conducted since 2002). Twelve adult patients (8 males and 4 females ) were studied, their age range from 22-56 years, They suffered from severe avascular necrosis( AVN) of their hip joints (six of them bilateral and other six unilateral ), all of them were with stage IV (according to Ficat and Arlet X- ray staging), and all of them were treated by Girdlestone resection arthroplasty.Pain relief achieved in 16 hips (88.9%) and in 16 hips (88.9%) there was good range of motion (ROM). Eight patients (66.6%) had good walking ability, while two patients (16.6%) were able to indoor walking with aids and the remaining two (16.6%) were chair bound.Overall eight patients (66.7%) expressed their satisfaction with the Girdlestone procedure, although the functional outcome seems to be quite less favourite.The main disadvantage was proximal migration of femur mostly between 4-8cm in 9 patients (74.9 %) which measure from x-ray whether unilateral or bilateral Girdlestone.infection pre-existed in two patients (one patient has infected dynamic hip screw and other patient has postoperative infection after core decompression surgery) both of them cured postoperatively.One patient converted to total hip arthroplasty after one year due to unstable gait.All the patients are followed over different periods of time, in six patients (50%) follow up over period less than 2 years and other six follow up range from 2-8 years.The Girdlestone operation appears as a viable solution to achieve pain relief and to control infection at the cost of limited mobility and function, in this specific subgroup of patients with severe AVN of femoral head.
Ameer Mohammad Muslem, Mohammed Naser Hussein, Abdulkareem Qasim Hussein. Evaluation of girdlestone operation as treatment option for avascular necrosis of femoral head. International Journal of Surgery Research, Volume 3, Issue 2, 2021, Pages 48-50