Girdlestone Resection Arthroplasty: Difference between revisions
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== History == | == History == | ||
This surgical procedure was first described by an English Orthopaedic surgeon, Gathorne Robert Girdlestone in 1928. The procedure has been known by his name ever since. It was first used for chronic septic arthritis of the hip, mostly arising from Tuberculosis. As there was not yet good access to antibiotics and arthroplasty, this procedure was used to resect the femoral head, to relieve the pain and source of infection. <ref>Vincenten CM, Gosens T, van Susante JC, Somford MP. [https://doi.org/10.7150/jbji.36618 The Girdlestone situation: a historical essay]. Journal of Bone and Joint Infection 2019;4:203-208</ref><ref>Than J, Jiganti M, Tedesco N. [https://doi.org/10.1016/j.artd.2021.09.008 Simultaneous primary bilateral hip resection arthroplasty] . Arthroplasty Today 2021;12:24-28</ref> | This surgical procedure was first described by an English Orthopaedic surgeon, Gathorne Robert Girdlestone in 1928. The procedure has been known by his name ever since. It was first used for chronic septic arthritis of the hip, mostly arising from Tuberculosis. As there was not yet good access to antibiotics and arthroplasty, this procedure was used to resect the femoral head, to relieve the pain and source of infection. <ref name=":0">Vincenten CM, Gosens T, van Susante JC, Somford MP. [https://doi.org/10.7150/jbji.36618 The Girdlestone situation: a historical essay]. Journal of Bone and Joint Infection 2019;4:203-208</ref><ref>Than J, Jiganti M, Tedesco N. [https://doi.org/10.1016/j.artd.2021.09.008 Simultaneous primary bilateral hip resection arthroplasty] . Arthroplasty Today 2021;12:24-28</ref> | ||
The method and techniques used in this surgery have evolved over time. | |||
== Description == | == Description == | ||
The | The first documented surgery of this kind, in 1928, involved radical excision to drain the tuberculous hip. A transverse incision of 5-6 inches (12-15cm) long with its centre near the greater trochanter is made, which exposes the gluteal muscles and fascia. All deep tissues, including greater trochanter and the gluteal muscles are removed. A transfer wedge is removed to allow the surgeon access to the joint and surrounding area. All decayed bone and septic debris is removed. The cavity is packed with gauze wicks and rubber drains to ensure drainage and control secondary granulation. The skin flaps are drawn back and stitched into the periosteum to prevent sinus-track from forming, to reduce the pain of dressings and allowing covering of the raw areas with excessive granulation.The subcutaneous and muscle tissues are largely covered, decreasing the granulating surface. A spica splintage was fitted for the patient. The 3 main goals of this surgery was to remove dead and devitalised tissues, flatten down dead spaces, and allow drainage so the wound would heal from the bottom. <ref name=":0" /> | ||
The | The surgery described above is no longer used and it has been modified by many surgeons all over the world. | ||
Once the femoral head has been resected, the clinical situation that remains is referred to as the 'Girdlestone situation'. | Once the femoral head has been resected, the clinical situation that remains is referred to as the 'Girdlestone situation'. | ||
Revision as of 19:25, 23 April 2023
Original Editor - Kirsten Coutts
Top Contributors - Kirsten Coutts and Lucinda hampton
History[edit | edit source]
This surgical procedure was first described by an English Orthopaedic surgeon, Gathorne Robert Girdlestone in 1928. The procedure has been known by his name ever since. It was first used for chronic septic arthritis of the hip, mostly arising from Tuberculosis. As there was not yet good access to antibiotics and arthroplasty, this procedure was used to resect the femoral head, to relieve the pain and source of infection. [1][2]
The method and techniques used in this surgery have evolved over time.
Description[edit | edit source]
The first documented surgery of this kind, in 1928, involved radical excision to drain the tuberculous hip. A transverse incision of 5-6 inches (12-15cm) long with its centre near the greater trochanter is made, which exposes the gluteal muscles and fascia. All deep tissues, including greater trochanter and the gluteal muscles are removed. A transfer wedge is removed to allow the surgeon access to the joint and surrounding area. All decayed bone and septic debris is removed. The cavity is packed with gauze wicks and rubber drains to ensure drainage and control secondary granulation. The skin flaps are drawn back and stitched into the periosteum to prevent sinus-track from forming, to reduce the pain of dressings and allowing covering of the raw areas with excessive granulation.The subcutaneous and muscle tissues are largely covered, decreasing the granulating surface. A spica splintage was fitted for the patient. The 3 main goals of this surgery was to remove dead and devitalised tissues, flatten down dead spaces, and allow drainage so the wound would heal from the bottom. [1]
The surgery described above is no longer used and it has been modified by many surgeons all over the world.
Once the femoral head has been resected, the clinical situation that remains is referred to as the 'Girdlestone situation'.
Also referred to as : Hip resection arthroplasty, Girdlestone procedure, Girdlestone excision arthroplasty of Hip and Femoral head ostectomy.
Indication
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Clinical Presentation[edit | edit source]
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Diagnostic Tests[edit | edit source]
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Pre-Op[edit | edit source]
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Post-Op[edit | edit source]
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Resources
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References[edit | edit source]
- ↑ 1.0 1.1 Vincenten CM, Gosens T, van Susante JC, Somford MP. The Girdlestone situation: a historical essay. Journal of Bone and Joint Infection 2019;4:203-208
- ↑ Than J, Jiganti M, Tedesco N. Simultaneous primary bilateral hip resection arthroplasty . Arthroplasty Today 2021;12:24-28
