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

Dennis R Roy

doi:10.1093/jhps/hnv070

Abstract

Arthroscopy of the pediatric hip began in 1977 with a publication by Gross. Interest was relatively slow to develop in the 1980s and 1990s. Coupled with the success of hip arthroscopy in the adult, interest heightened in applying the procedure to a variety of pediatric hip disorders, given that the alternative was an open surgical hip dislocation. The success of this initial group of pediatric hip arthroscopist’s has further expanded the application of hip arthroscopy as the primary or adjunct procedure for the management of intra-articular problems of the pediatric hip.

Highlights

Gross [1], in 1977, introduced the era of arthroscopy of the hip in children by utilizing the procedure in 28 patients (24 less than 10-year old) as an adjunct in a variety of pediatric orthopedic conditions including developmental dysplasia of the hip (DDH), Legg–Calve–Perthes disease (LCPD), neuropathic subluxation, prior sepsis and slipped capital femoral epiphysis (SCFE)
Most early hip arthroscopy experience in pediatric orthopedics was related to the residual pathology of developmental conditions (DDH, LCP and SCFE) and involved loose body removal and debridement of a torn labrum or ligamentum teres
Pediatric orthopedic surgeons have long dealt with hinge abduction secondary to residual deformity from LCP, SCFE, AVN, etc. [11,12], but a more refined view of the etiology of intra-articular damage was sparked by research published by Leunig and Ganz [13] on the concepts of femoral acetabular impingement (FAI)

Summary

INTRODUCTION

Gross [1], in 1977, introduced the era of arthroscopy of the hip in children by utilizing the procedure in 28 patients (24 less than 10-year old) as an adjunct in a variety of pediatric orthopedic conditions including developmental dysplasia of the hip (DDH), Legg–Calve–Perthes disease (LCPD), neuropathic subluxation, prior sepsis and slipped capital femoral epiphysis (SCFE). He utilized a 2.2-mm arthroscope with an anterior portal (lateral to the vessels) and a subadductor portal.

Number Age range of patients

SPECIFIC DISORDERS

Findings

CONCLUSION