Girdlestone arthroplasty.

A series of 92 patient who underwent excision arthroplasty of the hip (Girdlestone arthroplasty) as a primary procedure is presented. The operation was performed for various conditions which included femoral neck fracture, rheumatoid arthritis, ankylosing spondylitis, tuberculosis, septic arthritis, unreduced posterior dislocation of long duration, fracture of the acetabulum, avascular necrosis of femoral head and bony ankylosis. Excision of head and neck of the femur was found to be an excellent salvage procedure for infected hips especially yielding uniformly satisfactory results at all ages irrespective of the disease. It provided a painless, mobile hip. Except for shortening and unstable gait, no other handicap was observed; the disadvantages of this handicap were outweighed by its advantages, compared with the disadvantages of other sophisticated hip operations such as replacement, and mould arthroplasties or even total hip replacement. Our results were excellent in 21% of cases, good in 44% and fair in 26% while they were poor in 9%. In view of its functional end results, we feel that this measure can be a good alternative to more modern and sophisticated hip operations in the form of partial or total hip replacement under Indian conditions.