Langzeitresultate der Resektionsarthroplastik nach Girdlestone beim therapierefraktären Hüftgelenkinfekt

Esenwein, S. A.; Robert, Karen; Kollig, E.; Ambacher, T.; Kutscha-Lissberg, F.; Muhr, G.

doi:10.1007/s001040170040

Cited by 40 publications

(8 citation statements)

References 16 publications

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“…Although CaP coating makes a metallic implant bioactive by inducing osteoconductivity, osteoinductivity can only be induced by osteogenic drug or growth factors. Since almost all coating techniques involve high temperature in-processing or post-processing, any kind of drug or growth factors are only introduced after the coating process is done and mostly by adsorption [102,116,129]. This leads to a potential burst release effect of the loosely bonded drugs or growth factors.…”

Section: Drug Delivery From Cap Coatingsmentioning

confidence: 99%

Calcium phosphate ceramic systems in growth factor and drug delivery for bone tissue engineering: A review

2012

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Calcium phosphates (CaPs) are the most widely used bone substitutes in bone tissue engineering due to their compositional similarities to bone mineral and excellent biocompatibility. In recent years, CaPs, especially hydroxyapatite and tricalcium phosphate, have attracted significant interest in simultaneous use as bone substitute and drug delivery vehicle, adding a new dimension to their application. CaPs are more biocompatible than many other ceramic and inorganic nanoparticles. Their biocompatibility and variable stoichiometry, thus surface charge density, functionality, and dissolution properties, make them suitable for both drug and growth factor delivery. CaP matrices and scaffolds have been reported to act as delivery vehicles for growth factors and drugs in bone tissue engineering. Local drug delivery in musculoskeletal disorder treatments can address some of the critical issues more effectively and efficiently than the systemic delivery. CaPs are used as coatings on metallic implants, CaP cements, and custom designed scaffolds to treat musculoskeletal disorders. This review highlights some of the current drug and growth factor delivery approaches and critical issues using CaP particles, coatings, cements, and scaffolds towards orthopedic and dental applications.

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Section: Drug Delivery From Cap Coatingsmentioning

confidence: 99%

Calcium phosphate ceramic systems in growth factor and drug delivery for bone tissue engineering: A review

2012

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“…Unanimously, the functional results of standard resection arthroplasty are assessed as poor in the available literature. 12 13 14 17 18 19 20 21 22 23 24 As reported, almost half of geriatric patients were unable to walk; only one third could ambulate using supporting devices. 14 17 22 All our elderly patients were able to walk after completion of treatment with the Ilizarov apparatus.…”

Section: Discussionmentioning

confidence: 97%

“… 14 The procedure can be used as a rescue technique for infected THR in the situations in which reimplantation is impossible or doubtful. 12 13 14 17 18 20 21 22 23 24 It controls infection in most cases, but leaves the patients with a poor ability to ambulate due to the instability at the pseudoarthrosis. Hip arthrodesis is not regarded as functional, but remains one of the ultimate methods to rescue a limb in difficult situations and studies show good hip fusion rates using external fixation.…”

Section: Introductionmentioning

confidence: 99%

Modified Girdlestone arthroplasty and hip arthrodesis using the Ilizarov external fixator as a salvage method in the management of severely infected total hip replacement

Клюшин

Ababkov

Ермаков

et al. 2016

IJOO

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Background:Resection arthroplasty or hip arthrodesis after total hip replacement (THR) can be used to salvage the limb in case with deep infection and severe bone loss. The Ilizarov fixator provides stability, axial correction, weight-bearing and good fusion rates.Materials and Methods:We retrospectively assessed the outcomes of 37 patients with severe periprosthetic infection after THR treated between 1999 and 2011. The treatment included implant removal, debridement and a modified Girdestone arthroplasty (29 cases) or hip arthrodesis (seven cases) using the Ilizarov fixator. The Ilizarov fixation continued from 45 to 50 days in the modified arthroplasty group and 90 days in the arthrodesis group. One case was treated using the conventional resection arthroplasty bilaterally.Results:Eighteen months after treatment, infection control was seen in 97.3% cases. Six hips were fused as one patient died in this group. Limb length discrepancy (LLD) averaged 5.5 cm. The Harris hip score ranged from 35 to 92 points. Hip joint motion ranged from 10° to 30° in the modified arthroplasty group. All subjects could walk independently or using support aids. No subluxation or LLD progression was observed.Conclusion:The modified Girdlestone arthroplasty and hip arthrodesis using the Ilizarov apparatus results in sufficient ability for ambulation and good infection control in cases of failed THR associated with severe infection.

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“…But this rate must be nuanced in the traditional African context and religious where the acceptance of its situation is of rule: “It is the will of God”. However, even in the literature, this rate is quite high: 60 to 91% [ 3 , 5 , 6 , 20 ], even in authors who report poor functional results [ 18 ]. Ultimately, even if the functional abilities of patients are not excellent, no author reports results frankly bad.…”

Section: Discussionmentioning

confidence: 99%

Is Head and Neck Resection of the Femur (Girdlestone’s Procedure) Still Relevant? Indications and Results About 24 Cases

Sawadogo¹,

Kafando²,

Korsaga³

et al. 2018

TOORTHJ

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Introduction:Head and neck resection of the femur was described by Girdlestone in 1928 in the treatment of coxalgia. Very invasive at the beginning, this intervention is much less so today, but the term of “Girdlestone’s operation” or “Girdlestone’s procedure” has remained in use. The reported results are controversial. In resource-limited countries, Girdlestone’s procedure is often indicated for lack of a better one. In this context, we report the results of a series of 24 patients operated in a regional hospital (Ouahigouya, Burkina Faso) with the aim of showing that this technique remains valid and can be benefit. Methods: This was a retrospective descriptive study of 24 patients who had benefited from the procedure for cervical fracture sequelae, failure of arthroplasty or osteosynthesis, or osteonecrosis. All were operated by posterolateral approach, under spinal anesthesia and followed for 5 years with evaluation of the anatomical and functional results using the rating of Postel and Merle d'Aubigné (PMA). Results: All patients had Trendelenburg lameness with a mean shortening of 3.5 cm. They were all autonomous with walking aids and the PMA score ranged from 16 to 14. Discussion: although the results obtained are not excellent, they are relatively good and have allowed all our patients to recover an acceptable autonomy, compatible with certain independence in everyday life. Conclusion:The Girdlestone’s procedure cannot be a first intention indication, but retains a place in the therapeutic arsenal of certain affections of the hip.

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Langzeitresultate der Resektionsarthroplastik nach Girdlestone beim therapierefraktären Hüftgelenkinfekt

Abstract: In the long run the Girdlestone procedure still seems to be a reasonable salvage operation for persisting deep infections following hip surgery.

Cited by 40 publications

References 16 publications

Calcium phosphate ceramic systems in growth factor and drug delivery for bone tissue engineering: A review

Calcium phosphate ceramic systems in growth factor and drug delivery for bone tissue engineering: A review

Modified Girdlestone arthroplasty and hip arthrodesis using the Ilizarov external fixator as a salvage method in the management of severely infected total hip replacement

Is Head and Neck Resection of the Femur (Girdlestone’s Procedure) Still Relevant? Indications and Results About 24 Cases

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