The Girdlestone procedure is a type of surgery performed on individuals experiencing severe, painful hip conditions, and is generally only used in circumstances where no other options are viable.
Although the Girdlestone process reduces pain, it also comes with unavoidable risks and drawbacks, which need to be considered carefully by the patient and the medical professional involved.
What is the Girdlestone procedure?
Named after Gathorne Girdlestone, a professor of orthopaedic surgery from Oxford, the procedure involves removing part of the ball of the thigh bone or femur, allowing it to fuse with the hip socket (acetabulum) in the straight leg position.
The process - also known as resection arthroplasty of the hip - was devised for treating tuberculosis of the hip before joint replacement techniques became viable.
In what circumstances are Girdlestone procedures recommended?
The Girdlestone procedure is usually used when the patient has a severely painful hip and a total hip replacement has been ruled out as a surgical option. It may also be used when a total hip replacement has loosened, or when the hip bone has disintegrated as a result of arthritis or infection.
In some cases, this procedure is required because a person has had numerous hip replacements and cannot have any more. This sometimes occurs where there has been a failure to diagnose developmental dysplasia of the hips (also known as congenital dislocation of the hips) as a baby or child.
Delayed diagnosis of dysplasia requires more complex treatment, and has a less successful outcome than when dysplasia is diagnosed early. Often a delay in diagnosis results in a patient needing their first hip replacement in their 40s.
Generally speaking, the Girdlestone procedure is seen as a last resort or “salvage procedure”, only to be used when all other alternatives have been dismissed.
What are the risks and downsides of Girdlestone procedures?
Although the Girdlestone procedure is effective in addressing joint pain, the most prominent downside is that it leaves the affected limb shorter than the other, meaning the patient will require crutches or a cane to walk postoperatively. In more severe cases, the patient will become reliant on a wheelchair.
The leg will also be locked into a straight position as it can no longer bend at the hip, hampering movement. Any decision to undergo this type of surgery will therefore need to balance their mobility requirements with their current level of pain.
It is also worth noting that issues can occur during the Girdlestone procedure: for example, the joint cavity may become infected and sealed off, or the sciatic nerve could be injured.
What are the signs of needing hip surgery?
Hip surgery of any kind is considered a major operation, and is normally only recommended if other treatments - such as physiotherapy or steroid injections - have failed to alleviate the pain.
Signs that surgery may be needed include:
- severe pain, swelling and stiffness in the hip joint that hampers mobility
- pain so severe that it interferes with quality of life and sleep
- difficulty completing everyday tasks, such as shopping, working and socialising
- feelings of depression caused by the pain and lack of mobility
If the individual has been struggling with any or all of these problems and no other treatment approach has proven effective, then a Girdlestone procedure may be considered.
How can orthopaedic surgery patients find out more?
If you have concerns about developmental dysplasia of the hips, Girdlestone procedures or another type of hip surgery and are looking for additional information and support, there are a number of organisations and resources that may be useful to you:
- Versus Arthritis
- Royal College of Surgeons
- Hillingdon Hospital
- NHS information on hip replacements
Alternatively, if you feel that you have been the victim of medical negligence that has affected your quality of life, then the expert solicitors at Potter Rees Dolan may be able to help. Visit our orthopaedic negligence claims page to find out more, or give us a call on 0800 027 2557.