Hip Arthroscopy in Children under the Age of Ten

Abstract

Arthroscopic hip surgery has become an established diagnostic and therapeutic method for addressing different hip pathologies. This paper focuses on hip arthroscopy for treating hip disorders in children under the age of 10. Arthroscopic hip surgery was performed 30 times on 24 children to address various hip pathologies. Indications were septic arthritis, benign soft tissue tumors, traumatic and congenital hip dislocation, juvenile idiopathic arthritis and osteochondroma of the acetabulum. Diagnostic arthroscopy was technically feasible in all cases. All cases of septic arthritis were successful treated using arthroscopic lavage and antibiotics. In the miscellaneous cases (benign fibrous tumor, juvenile idiopathic arthritis, osteochondroma congenital hip dislocations and traumatic hip dislocation) 4 hips had additional open surgery including surgical dislocation with synovectomy, open reduction and stabilization of the fractured posterior rim of the acetabulum, acetabulopasty and open resection of an osteochondroma with acetabuloplasty. In conclusion arthroscopic hip surgery is an additional diagnostic and therapeutic method that is suitable for treating different hip pathologies in children under the age of 10. Primary treatment of septic arthritis can be done easy by hip arthroscopy. Using cannulated mini arthroscopic hip instruments (2.7 mm), the range of application can be expanded to include treatment of very young infants. Hip arthroscopy can reduce the need of open surgery but cannot replace bony procedures in hip surgery.

SEIP–SERPE–SEOP Consensus document on the treatment of uncomplicated acute osteomyelitis and septic arthritis

“…13 Other authors propose arthroscopy as a less aggressive method than arthrotomy for treating SA in children. 6,23,24 The main limitations are the age of the patients and the difficulty of the procedure.…”

The use of hip arthroscopy in the management of the pediatric hip

“…Interest grew as hip arthroscopy was perceived as a less invasive way to treat intra-articular problems. As more experience was gained, a number of reviews have been published on the use and efficacy of hip arthroscopy in the pediatric age group [ 6–9 ], including one publication on patients less than 10 years of age [ 10 ].…”