Surgical therapy of hip-joint empyema. Is the Girdlestone arthroplasty still up to date?

Oheim, Ralf; Gille, Justus; Schoop, R.; Mägerlein, Sonja; Grimme, C.; Jürgens, Christian; Gerlach, Ulf-Joachim

doi:10.1007/s00264-011-1351-2

Cited by 30 publications

(23 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The sensitivity seems to be related to the amount of biopsies taken [32]. Antibiotics administered for perioperative prophylaxis, as well as extended transportation time, inadequate quantities of vital bacteria and preservation of specimens before processing may all lead to negative culture results [33].…”

Section: Discussionmentioning

confidence: 99%

Is non-union of tibial shaft fractures due to nonculturable bacterial pathogens? A clinical investigation using PCR and culture techniques

Gille

Wallstabe

Schulz

et al. 2012

Journal of Orthopaedic Surgery and Research

Self Cite

View full text Add to dashboard Cite

BackgroundNon-union continues to be one of the orthopedist’s greatest challenges. Despite effective culture methods, the detection of low-grade infection in patients with non-union following tibial fracture still presents a challenge. We investigated whether “aseptic” tibial non-union can be the result of an unrecognized infection.MethodsA total of 23 patients with non-union following tibial shaft fractures without clinical signs of infection were investigated. Intraoperative biopsy samples obtained from the non-union site were examined by means of routine culture methods and by polymerase chain reaction (PCR) for the detection of 16 S ribosomal RNA (rRNA). Control subjects included 12 patients with tibial shaft fractures.Results23 patients (8 women and 15 men; mean age: 47.4 years) were included into this study. Preoperative C-reactive protein levels (mean: 20.8 mg/l) and WBC counts (mean: 8,359/μl) in the study group were not significantly higher than in the control group. None of the samples of non-union routine cultures yielded microorganism growth. Bacterial isolates were found by conventional culturing methods in only 1 case of an open fracture from the control group. In this case, PCR yielded negative results. 16 S rRNA was detected in tissue specimens from 2 patients (8.7%) with non-union. The analysis of these variable species-specific sequences enabled the identification of specific microorganisms (1x Methylobacterium species, 1x Staphylococcus species). Both PCR-positive patients were culture-negative.ConclusionsThe combination of microbiological culture and broad-range PCR seems to substantially add to the number of microbiological diagnoses obtained and may improve the clinican’s ability to tailor therapy to the individual patient’s needs.

show abstract

Section: Discussionmentioning

confidence: 99%

Is non-union of tibial shaft fractures due to nonculturable bacterial pathogens? A clinical investigation using PCR and culture techniques

Gille

Wallstabe

Schulz

et al. 2012

Journal of Orthopaedic Surgery and Research

Self Cite

View full text Add to dashboard Cite

show abstract

“…Girdlestone [1] as a radical surgical technique to address complications from hip joint infections. Today, it is considered a salvage procedure done as a last resort in the presence of significant infection, poor bone stock, or failed total hip arthroplasty (THA) [2,3]. The surgery involves removal of the femoral head to the lesser trochanter, approximation of the femur into the acetabulum, and reattachment of associated soft tissue.…”

Section: Introductionmentioning

confidence: 99%

“…The surgery involves removal of the femoral head to the lesser trochanter, approximation of the femur into the acetabulum, and reattachment of associated soft tissue. Although the procedure is considered appropriate and effective in the presence of a hip infection and in reducing pain, complete return to functional activities may be limited [2]. Limitations in active and passive range of motion, gait, and function are commonly reported [4,5].…”

Section: Introductionmentioning

confidence: 99%

Successful Rehabilitation of a Young Adult With Total Hip Arthroplasty a Decade After a Girdlestone Procedure: A Case Presentation

Marinko

Christie

Lewis

2015

PM&R

View full text Add to dashboard Cite

This is a case report of a female who underwent a Girdlestone arthroplasty at age 10 and a total hip arthroplasty at age 21. Despite early post-operative rehabilitation, the patient experienced increasing pain, progressive gait deviations and functional limitations during the year following surgery. This course of care was initiated one year after surgery and focused on motor retraining to address pain and gait deviations. This case demonstrates that positive outcomes can be achieved after longstanding musculoskeletal dysfunction is corrected, but that prolonged rehabilitation may be necessary to produce changes in movement patterns at both the local (joint and muscle) and central (cortical) levels. Correction of both the structural problem and the learned movement patterns is necessary for a successful outcome.

show abstract

“…A resection arthroplasty of the hip joint (Girdlestone) has been described for alleviation of pain and improvement in hip function, but this arthroplasty produces an unstable joint, limb-length discrepancy and functional disability [10]. The pelvic support osteotomy (PSO) was introduced to improve hip stability by directly transferring the body weight to the distal femur and to relieve pain by offloading the stump of the femoral head [6, 11, 12].…”

Section: Discussionmentioning

confidence: 99%

Midterm results of Ilizarov hip reconstruction for late sequelae of childhood septic arthritis

El-Rosasy

Ayoub

2014

Strategies in Trauma and Limb Reconstruction

View full text Add to dashboard Cite

The management of hip instability as a consequence of septic arthritis in childhood is difficult. Ilizarov hip reconstruction is a double-level femoral osteotomy with the objective of eliminating hip instability, through a proximal valgus–extension–derotation osteotomy and a distal varization–lengthening osteotomy for mechanical axis correction and equalization limb length. Ilizarov hip reconstruction was performed for 16 adult patients with complaints of hip pain, leg-length discrepancy, limping, reduced activity and limited abduction of the hip as a result of childhood septic arthritis. Their ages ranged from 19 to 32 years (mean 23.2 ± 4.2). Ilizarov external fixator was used in all cases. At the time of last follow-up that ranged from 60 to 132 months (mean 85.6 ± 23.5), the Harris hip score (HHS) showed excellent functional outcome in two cases (12.50 %), good in 13 cases (81.25 %) and fair in one case (6.25 %). There was no poor functional outcome in any case. Preoperatively, the mean HHS was 56.18 points, and at the time of last follow-up, it improved to a mean of 84.62 points. Pain subsided in all patients, the Trendelenburg sign became negative in all but three (19 %) patients, no patient had limb-length discrepancy, and the alignment of the extremity was reestablished in all cases. No additional operations were required. Ilizarov hip reconstruction is a valuable and durable solution for the late sequelae of childhood septic arthritis of the hip presenting in adult patients.

show abstract

Surgical therapy of hip-joint empyema. Is the Girdlestone arthroplasty still up to date?

Cited by 30 publications

References 18 publications

Is non-union of tibial shaft fractures due to nonculturable bacterial pathogens? A clinical investigation using PCR and culture techniques

Is non-union of tibial shaft fractures due to nonculturable bacterial pathogens? A clinical investigation using PCR and culture techniques

Successful Rehabilitation of a Young Adult With Total Hip Arthroplasty a Decade After a Girdlestone Procedure: A Case Presentation

Midterm results of Ilizarov hip reconstruction for late sequelae of childhood septic arthritis

Contact Info

Product

Resources

About