ArticleResearch square2026
Age-Stratified Indications and Complications of Girdlestone Hip Resection Arthroplasty: A Retrospective Cohort Study.
Article in Research square, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Girdlestone hip resection arthroplasty (GRA) is a salvage procedure reserved for recalcitrant periprosthetic infection, failed arthroplasties, as well as neuromuscular hip dislocations in children. Existing evidence derives largely from single-institution, age-restricted studies. Therefore, the purpose of this study was to report demographic, diagnostic, and complication profiles of GRA across the population in a large retrospective cohort. Methods: We conducted a retrospective cohort study using the TriNetX Research Network, a federated network of deidentified electronic health record data. Patients who underwent Girdlestone resection arthroplasty between October 2015 and June 2024 were identified and stratified into pediatric (≤ 18 years) and adult (> 18 years) cohorts. Demographics, the ten most prevalent International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnoses per cohort, and postoperative outcomes, including return to the operating room, pain, opioid use, heterotopic ossification, decubitus ulcers, infection, and death, were assessed. Results: A total of 1,876 patients were identified: 87 pediatric (≤ 18 years) and 1,789 adult (> 18 years) patients. The leading pediatric diagnosis was cerebral palsy. The adult diagnostic profile was less homogeneous and included unclassified pain (4%) and other unclassified joint disorder (4%), followed by pressure ulcer, paraplegia/quadriplegia, and cerebral palsy (3% each). A diagnosis of cerebral palsy was present in both cohorts (28% pediatric vs 3% adult). Pain occurred at similar rates in both groups (57.5% pediatric vs 60.8% adult; P = 0.575). Opioid use (11.7%), return to the operating room (10.0%), decubitus ulcers (28.3%), surgical site infection (5.3%), pyogenic arthritis (23.6%), osteomyelitis (12.8%), sepsis (9.1%), and death (11.4%) occurred only in the adult cohort (all P ≤ 0.020). Heterotopic ossification occurred only in adults (1.1%; P = 1.000). Conclusions: Girdlestone resection arthroplasty was associated with distinct indications and outcomes across age groups. Pediatric patients underwent the procedure predominantly for neuromuscular hip disease, while adults carried a high burden of infection, reoperation, and mortality. These findings support age-specific risk counseling rather than a single composite risk estimate. Type of study/level of evidence: Retrospective comparative study; Level III.
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