Comparison of the results of the Girdlestone pseudarthrosis with reimplantation of a total hip replacement.

A Girdlestone pseudarthrosis of the hip (resection arthroplasty) is nowadays mainly carried out for failed hip replacements. A decision may have to be made whether to reimplant a new hip prosthesis or to accept the result of a pseudarthrosis. We followed 2 groups of patients: 32 patients had a long standing pseudarthrosis; in the other group of 16 patients, a total hip replacement was reimplanted at an average of 3 years after a pseudarthrosis. The improvement in hip function after the reimplantation was marginal and the results were comparable to a good functioning pseudarthrosis. However, personal satisfaction and the activities of daily living were better in the reimplantation group, and their Harris hip score was 64 compared to 58 in those with a pseudarthrosis. The Girdlestone procedure still seems to be a reasonable salvage operation for some complications following hip surgery, but when there are the correct indications, reimplantation of a total hip prosthesis is recommended.