Case Report Successful salvage of an unstable Girdlestone's excision arthroplasty with a megaprosthesis of the hip Raju Vaishya MS MCh FRCS a , Vipul Vijay MS DNB DipSICOT b,* , Abhishek Vaish MS c a Senior Consultant, Department of Orthopaedics, Indraprastha Apollo Hospital, New Delhi 110067, India b Consultant, Department of Orthopaedics, Indraprastha Apollo Hospital, New Delhi 110067, India c Student, Department of Orthopaedics, Indraprastha Apollo Hospital, New Delhi 110067, India article info Article history: Received 24 December 2014 Accepted 16 March 2015 Available online xxx Keywords: Excision arthroplasty Instability Hip Total hip replacement (THR) Revision abstract The functional results after a Girdlestone's excision arthroplasty of the hip are unpre- dictable with high patient dissatisfaction and complication rates. We report such a case of symptomatic patient, which was managed successfully with a megaprosthesis of the hip with constrained acetabular liner. The use of megaprosthesis for a failed and symptomatic Girdlestone's excision arthroplasty of the hip has not been reported before. Copyright © 2015, Delhi Orthopaedic Association. All rights reserved. 1. Background Girdlestone's excision arthroplasty was first described by Girdlestone 1 as a salvage procedure for tuberculosis of the hip. The resection arthroplasty usually results in significant alteration of the hip function alone with shortening and instability 2 which is usually very disabling to the patient. This had lead to its decreased popularity amongst the patients and orthopaedic surgeons until advent of total hip replacement (THR), which again lead to the resurgence of Girdlestone's resection arthroplasty for the salvage of infected THRs. Chronic infection in the hip after THR is a devastating complication and is conventionally managed in staged manner, firstly eradicating the infection by excision arthro- plasty, followed by re-implantation of THR. Conversion of Girdlestone arthroplasty to a revision THR is fraught with possibility of complications, including re-infection and dislo- cation etc. 3,4 Revision THR poses a significant challenge in these patients, as many a times the bone stock and soft tissues are deficient, hence conventional THR may not be possible, in all cases. Since, the prevention of infection is of major concern to the surgeon in revision surgery, the functional outcome and parameters influencing function after conversion have been * Corresponding author. Tel.: þ91 9811723671 (mobile). E-mail address: dr_vipulvijay@yahoo.com (V. Vijay). Available online at www.sciencedirect.com ScienceDirect journal homepage: www.elsevier.com/locate/jcot journal of clinical orthopaedics and trauma xxx (2015) 1 e4 http://dx.doi.org/10.1016/j.jcot.2015.03.005 0976-5662/Copyright © 2015, Delhi Orthopaedic Association. All rights reserved. Please cite this article in press as: Vaishya R, et al., Successful salvage of an unstable Girdlestone's excision arthroplasty with a megaprosthesis of the hip, Journal of Clinical Orthopaedics and Trauma (2015), http://dx.doi.org/10.1016/j.jcot.2015.03.005