Amputation through the hip joint during the pre-anaesthetic era.

Even to the present day, hip disarticulation is one of the most radical orthopaedic operations. First carried out on the Continent in 1774 and in Britain in 1779, this procedure was only deemed necessary in circumstances where death was otherwise inevitable. George James Guthrie claimed to have undertaken the first amputation through the hip joint in which the patient survived. We describe some of these cases from the pre-anaesthetic surgical literature in which amputation through the hip joint was undertaken, and we comment on the surgical techniques used. This information is complemented by the views of certain authorities on this procedure. Many surgeons during the first half of the 19th century, including Guthrie, sought alternative surgical operations to hip joint disarticulation. The removal of the head and neck of the femur was far less traumatic than disarticulation through the hip joint, and proved an extremely effective alternative procedure for lesions involving the proximal part of the femur where there was any possibility that the limb could be saved. Copyright 2003 Wiley-Liss, Inc.