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Musculoskeletal Imaging

Girdlestone arthroplasty

a surgical procedure on the hip joint in which extensive debridement and resection of para-articular bone are employed. Girdlestone arthroplasty is used in the treatment of infection after hip replacement (Fig.1). Some of the indications for performing this technique are given in Table 1.

Girdlestone arthroplasty, Table 1. Some indications for Girdlestone arthroplasty.

Presence of virulent, resistant organisms
Presence of Gram-negative organisms
Presence of two or more strains of organisms
Unhealthy and oedematous soft tissues
Draining sinus
Radiographic evidence of well-established osteomyelitis with bone erosion
Severe loss of bone substance

The arthroplasty has inevitable sequelae, including a Trendelenburg gait, shortening of the involved extremity and joint instability, which make ambulation difficult for the patient.

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Fig.1

a. AP radiograph of the pelvis demonstrates narrowing of the right hip joint due to septic arthritis. b. Post-operative radiograph demonstrates resection of the proximal femur, which is referred to as a girdlestone arthroplasty.
Girdlestone arthroplasty, Fig.1 (a)
Girdlestone arthroplasty, Fig.1 (b)