I do not have any experience with BILATERAL Girdlestone situation. In the past twenty years I had four patients with UNIlateral GIrdlestone procedures (three due to recurrent infections, one due to other reasons). Three went ahead very well, one patient insisted on re-operation and re-insertion of a THR two years after removal. We did it. She is happy (mostly because the leg length is equal again), objectively I am not that much (ROM etc). The three remaining patients with Girdlestone situation are apparently quite satisfied and do not want any other procedure again.

Prof. Niklaus F. Friederich, Basel/Dornach

Thank you, Prof. Friederich for your answer. Recently, I had a 57-year old patient with bilateral Girdlestone hips for infected THR (after removal). I was very concerned with her walking ability. I have never had a similar (bilateral) case before. Anyway, we had to do. It was surprizing for me to see her out of bed on the 4th postoperative walking on 2 crutches (with difficulty, with bilateral Trendelenburg).  In the next 10 days she could climb stairs and we discharged her from hospital.  I wonder what will be the result on the follow-up in 2 months ?

I had a case with bilateral Girdlestone by infected hip prosthesis 30 years ago, the patient never accept a new rescue surgical intervention, despite this, he was able to walk with two crutches and had limited activity but was able to perform activities of daily living without pain. If I have had unilateral cases, approximately 40% of them have not accepted a rescue intervention, these patients have a great shortening, needed two crutches to walk but no pain

Thank you, Dr. Herrera, for sharing your experience. I agree entirely with you that re-replacement of hip endoprosthesis after infection should be done in elective cases. Re-THR at any price, which is  the trend nowadays, seems to me  very risky.

Dear Colleagues,

I recently was performing a bilateral Girdlestone in a very young patient (below 30a) , because of bilateral very painful hip osteonecrosis. The reason for that is a chronical osteomyelitis in the hip and pelvis and also in both knees. There is no implantation of an endoprosthesis planned, because the patient is very incompliant and has a history of  drug abuse. At the moment it is to early to report the clinical results, but in this case we hope to achieve a suffisticated mobilization without pain.

I agree with you, Dr. Lass. There are special cases where classical techniques like Girdlestone or Milch osteotomy still work.

I had a case with bilateral Girdlestone by infected hip prosthesis in a young patient with sickle cell desease she  is able to walk without crutches but with limp, she perform activities of daily living and work without pain. I plant to do a other case next month in an other young patient with sickle cell desease 

Thank you, Jean-Louis, for sharing this interesting case. My case, reported above (a 57-year-old patient with bilateral Girdlestone after infected THA), presented in my office for follow-up at 2 months postoperatively. As a whole she is doing well, still walks with 2 crutches, no significant pain complaints, no signs of infection. She was adviced to continnue kinesitherapy for strengthening of hip muscles and try walking with 1 crutch.