Hip Arthroscopy in the Pediatric and Adolescent Athlete

Abstract

Hip disorders are increasingly common in pediatric and adolescent athletes, being both idiopathic problems aggravated by sports and overuse injuries caused by sports. These disorders are a major cause of morbidity and their long-term consequences carry into adulthood. In the past these problems have been primarily treated with open surgery using a surgical hip dislocation, but due to improved instruments and techniques, hip arthroscopy is becoming a mainstay in their treatment. Arthroscopic management allows assessment and reconstructive treatment of most problems in practically all parts of the hip. Recent comparative studies have shown better clinical results, less complications and much faster recovery after arthroscopy when compared with open surgery for a number of indications, including impingement and labral tears. Typical pediatric hip disorders such as slipped capital femoral epiphysis (SCFE) and Legg-Calve-Perthes Disease (LCPD) may also benefit from hip arthroscopy. Analyzing complications, hip arthroscopy has also performed very well. What stands out as a risk factor is the need for experience in pediatric hip arthroscopy techniques, which have been described to be distinctly different from the approach to the adult hip. Also, an understanding of the growing anatomy is crucial. Finally, a thorough and well-directed postoperative therapy is pivotal to realize the best possible outcome.