168 THE JOURNAL OF BONE AND JOINT SURGERY EXCISION ARTHROPLASTY FOR INFECTED TOTAL HIP REPLACEMENTS

A study of excision arthroplasty (Girdlestone’s pseudarthrosis) for infected total hip replacements is presented. Twenty-two patients were reviewed with a minimum follow-up of one year. Reduction in pain was significant but the functional results were poor. Factors contributing to poor function were old age, poor medical condition and arthritis of the contralateral hip; these were in addition to the gross instability resulting from the pseudarthrosis. The patients were easily fatigued and dependent on external supports; calipers were found to be unacceptable. The symptoms after excision arthroplasty are compared with those before the original hip replacement. The relief of pain and restoration of function which follow total hip replacement may be severely compro-mised if deep sepsis supervenes. The treatment of such infection presents a formidable challenge. Any method of treatment which leaves the infected hip in situ is only sometimes successful and Charnley (1970) suggested that if it caused sufficient symptoms, the implant should be removed. More recently one-stage exchange arthroplast