Name of the Procedure:

Acetabuloplasty; resection, femoral head (e.g., Girdlestone procedure)

Summary

Acetabuloplasty, often referred to as the Girdlestone procedure, involves the surgical removal of the femoral head, the top part of the thigh bone that fits into the hip socket. This procedure is typically performed to relieve pain and manage severe hip joint infections or other hip problems when other treatments have failed.

Purpose

• Addresses severe hip joint infections, hip arthritis, or failed hip replacement surgeries.
• Aims to alleviate pain, remove infection, and improve the patient's ability to move.

Indications

• Chronic, severe hip infections not responding to other treatments.
• Debilitating hip arthritis.
• Failed hip replacement surgery with complications.
• Severe pain and functional impairment in the hip joint.

Preparation

• Patients may need to fast for several hours before the procedure.
• Medication adjustments, such as discontinuing blood thinners, may be necessary.
• Preoperative diagnostic tests, including blood tests, imaging studies (e.g., X-rays, MRI), and sometimes cultures to identify infection.

Procedure Description

1. The patient is placed under general anesthesia or regional anesthesia.
2. An incision is made over the hip joint to access the femoral head.
3. The femoral head is carefully resected (removed).
4. The area is thoroughly cleaned to remove any infected or damaged tissue.
5. The incision is closed, and a dressing is applied.

• Tools: Surgical instruments, including scalpels, forceps, and retractors.
• Technology: Imaging guidance, if necessary.
• Anesthesia: General anesthesia or regional anesthesia (e.g., spinal or epidural).

Duration

The procedure typically takes between 1 to 3 hours.

Setting

Performed in a hospital operating room.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technician

Risks and Complications

• Infection
• Blood loss
• Nerve damage
• Blood clots
• Persistent pain or instability in the hip region
• Need for additional surgeries

Benefits

• Pain relief is often achieved within weeks to months.
• Improved ability to move and perform daily activities.
• Potential reduction in infection and inflammation.

Recovery

• Hospital stay of several days.
• Physical therapy to aid in mobility and strength.
• Pain management with medications.
• Recovery typically spans several weeks to months.
• Follow-up appointments to monitor healing and progress.

Alternatives

• Antibiotic therapy for infections.
• Revision hip replacement surgery.
• Conservative treatments, such as physical therapy and pain management medications.
• Pros of alternatives: Less invasive, potential for preserving the hip joint.
• Cons of alternatives: May not be effective if infection or damage is extensive.

Patient Experience

• During: The patient will be under anesthesia and will not feel pain.
• After: Postoperative pain and discomfort managed with medications.
• Initial difficulty in mobility; use of walking aids like crutches or a walker.
• Gradual improvement in pain and mobility over the recovery period.