Hip joint communication with pressure sore: The refractory wound and the role of girdlestone arthroplasty

Gregory R D Evans, Victor L. Lewis, Paul Manson, Mario Loomis, Craig Vander Kolk

Research output: Contribution to journalArticle


Fifteen patients who underwent Girdlestone arthroplasty (proximal femoral head resection) were reviewed at The Johns Hopkins Hospital and Northwestern Memorial Hospital. Ages ranged from 24 to 57 years (mean 36.7 years). All patients were paraplegics or quadriplegics (C7-L3). All patients presented with signs of sepsis and had evidence of osteomyelitis. Soft-tissue reconstruction was most commonly performed with the vastus lateralis, and no femoral stabilization was used. There were no deaths. Recurrent ulcers at the site of the Girdlestone arthoplasty were found in 23 percent of patients in whom follow-up was possible. No recurrence was noted at the original site in 77 percent with a mean follow-up of 20 months. Additional pressure sores occurred at other nonsurgical sites in six patients at a mean of 23.3 months. Girdlestone arthroplasty with soft-tissue coverage is mandatory for successful treatment of pressure sores with hip joint involvement.

Original languageEnglish (US)
Pages (from-to)288-294
Number of pages7
JournalPlastic and Reconstructive Surgery
Issue number2
Publication statusPublished - 1993


ASJC Scopus subject areas

  • Surgery

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