Girdlestone Procedure

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.

In adults, the Girdlestone procedure is most commonly used to treat patients with serious hip problems who cannot undergo a hip replacement. It may be 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.

If you have experienced a hip condition that worsened as a result of a misdiagnosis or because symptoms were missed by your doctor, you may be entitled to claim compensation. The medical negligence solicitors at Potter Rees Dolan are extremely experienced in securing compensation for people who have suffered due to negligence, which can pay for any expenses incurred during their treatment and recovery, and help to make their recovery more comfortable.

Contact us to learn more about whether you are eligible to claim. Call us on 0800 027 2557, or fill in our online enquiry form and we will call you back at a time that is convenient for you.

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. It is usually seen as a last-resort treatment option, and will only be pursued if other pain-relief options have failed. This is because the procedure reduces mobility and makes it harder to walk, although patients can eventually put weight onto the leg.

In what circumstances are Girdlestone procedures recommended?

This need to resort to a 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, the Girdlestone procedure is the only way to relieve pain caused by a deep-seated infection in the hip cavity. 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. 

This is often caused by a failure to diagnose hip dysplasia in a young person. When the problem is not diagnosed early, it can lead to more serious symptoms, require more complex treatment, and have 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.

Unfortunately, doctors frequently miss hip dysplasia diagnoses because babies grow at irregular rates, and hip problems are common symptoms in other childhood conditions. If you or your child have suffered from hip dysplasia that was not diagnosed properly and have experienced negative side effects as a result, you might be able to bring a claim in clinical negligence. 

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 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:

• Steps
• Versus Arthritis
• Saga
• 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, give us a call on 0800 027 2557, or fill in the online enquiry form on this page to arrange a call back.