Abstract
OBJETIVOS: Avaliar a função e a qualidade de vida dos pacientes pós-artroplastia de Girdlestone e comparar os resultados entre os grupos Girdlestone unilateral e o grupo com prótese total de quadril contralateral. MÉTODOS: estudo transversal no qual foram avaliados 9 pacientes com Girdlestone unilateral e 3 com Girdlestone em um quadril e prótese total no quadril contralateral. A avaliação constitui-se em aplicar o questionário genérico de qualidade de vida SF-36 e um questionário funcional específico para o quadril, Harris Hip Score (HHS). A comparação dos grupos foi realizada usando-se o teste t- Student e o teste de Fisher. RESULTADOS: Os pacientes do grupo Girdlestone unilateral apresentaram maior quantidade de domínios do SF-36 classificados como elevados, embora 77,8% destes tenham obtido resultados ruins no HHS. Todos os pacientes apresentaram o teste de Trendelenburg positivo e discrepância de membros, o que levou à marcha claudicante em 11 dos 12 pacientes avaliados. Destes, apenas 6 submeteram-se a fisioterapia pós-operatória. CONCLUSÃO: A qualidade de vida e a função pós-operatória de Girdlestone, na população brasileira, ainda necessita ser mais pesquisada, pois estes resultados são indicações do comportamento das variáveis de estudo e não podem ser consideradas encerradas.
Highlights
Girdlestone’s arthroplasty was first performed and documented by Schmalz (1817) and White (1821) to treat children with coxofemoral joint tuberculosis[1,2,3]
In 1928, Girdlestone briefly described this procedure, using it for treating hip tuberculosis[4] and later, in 1943, Girdlestone globally disseminated this technique as a solution for treating septic and tuberculous hip pathologies(2, . 4-6) In 1960, with the development of hip replacement arthroplasty, resection arthroplasties were progressively left aside[3]
All subjects were submitted to assessment, which constituted of applying a generic questionnaire on quality of life, the SF-36, and a functional questionnaire specific to hip joint – the “Harris Hip Score”
Summary
Girdlestone’s arthroplasty was first performed and documented by Schmalz (1817) and White (1821) to treat children with coxofemoral joint tuberculosis[1,2,3]. The main objectives of this procedure are to promote pain relief[7,8,13,22,23], improve patient’s function[7,8,23], eradicate infection (when present)(22,23) and promote satisfaction[23] The advantages of this technique include the following: it can be used in cases where other kinds of arthroplasties are contraindicated; it provides long-term results, and; it may subsequently be converted into HTP[3,24]. At University of Florida, 21 patients were submitted to GRA after receiving a diagnosis of infected THP, and were reviewed after the procedure These patients’ outcomes suggested that resection arthroplasty for infected HTP provides poor functional results[8]. De Laat[6] concluded that arthroplasty as per Girdlestone, in some cases, constitutes the only solution for assuring a good quality of life for patients with hip joint pathologies; McElwaine and Colville[15]
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