Felis ISSN 2398-2950

Hip: excision arthroplasty

Synonym(s): Femoral head and neck amputation; Femoral head and neck ostectomy; Femoral head excision; Girdlestone procedure

Contributor(s): Noel Fitzpatrick, Melvyn Pond, J Yovich, Prof Mark Rochat

Introduction

  • Removal of femoral head and neck to create pseudoarthrosis of hip joint.

Uses

  • Salvage procedure for a variety of hip joint diseases, hip dysplasia Hip: dysplasia, acetabular/femoral head and neck fractures, chronic coxo-femoral luxation or luxation complicated by hip dysplasia.

Advantages

  • Requires relatively little instrumentation.
  • Requires less surgical assistance, especially if done with a powered sagittal saw.
  • Does not require expensive implants.
  • Does not require strict postoperative confinement.
  • Typically improves limb function considerably over preoperative status.

Disadvantages

  • Effectively reduces length of the limb so femoral shaft lies dorsal to normal position.
  • Reduces range of hip motion.
  • May not return to full function or have as much stamina and degree of function as that provided by total hip replacement.
  • Some degree of muscle atrophy invariably occurs.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Depends on integrity of surrounding soft tissues - too much scar tissue causes lameness due to reduced range of movement of pseudoarthrosis; pressure on sciatic nerve can cause lameness.
  • Immature animals respond better than adults.
  • Can be carried out bilaterally and simultaneously if required but requires extra nursing care.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Yap F W, Dunn A L, Garcia-Fernandez P M et al (2015) Femoral head and neck excision in cats: medium- to long-term functional outcome in 18 cats. J Feline Med Surg 17 (8), 704-10 PubMed.
  • Off W, Matis U (2010) Excision arthroplasty of the hip joint in dogs and cats. Clinical, radiographic, and gait analysis findings from the Department of Surgery, Veterinary Faculty of the Ludwig-Maximillians-University of Munich, Germany. 1997. Vet Comp Orthop Traumatol 23 (5), 297-305 PubMed.
  • Lippincott C L (1992) Femoral head and neck excision in the management of canine hip dysplasia. Vet Clin North Am Small Anim Pract 22 (3), 721-737 PubMed.


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