Hip arthroscopy has become an established procedure for certain indications in adults; however, experience in children and adolescents has been more limited. This article reviews the technique, indications, and results of hip arthroscopy in children and adolescents.
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[Show abstract][Hide abstract] ABSTRACT: Purpose of review Slipped capital femoral epiphysis is a common adolescent hip disorder. Management of chronic, stable slipped capital femoral epiphysis with in-situ screw fixation has been well defined, but controversy exists regarding management of the unstable hip disorder, the indications for prophylactic fixation of the contralateral hip and the role of osteotomy in the management of residual deformity. Recent findings Recent developments in the epidemiology, etiology, diagnosis and management of this hip disorder are reviewed. The importance of early diagnosis, the relationship of body mass index, the predictors for bilaterality and the role for osteotomies are reviewed and compared. Summary The information in this review will help clinicians identify patients at risk, understand the need for prompt diagnosis and recommend the appropriate management for both stable and unstable slipped capital femoral epiphysis. Further research is needed to better define the role of osteotomy in this disorder.
Preview · Article · Dec 2006 · Current Opinion in Orthopaedics
[Show abstract][Hide abstract] ABSTRACT: The goal of this study was to compare results of open arthrotomy versus arthroscopic drainage in treating septic arthritis of the hip in children.
This prospective controlled study was conducted on twenty patients (20 hips) with acute septic arthritis of the hip. Diagnosis was suspected if there was: a history of fever, non-weight-bearing on the affected limb, erythrocyte sedimentation rate (ESR) of at least 40 mm/h, and white blood cell count of more than 12,000 cells per cubic millimeter. Diagnosis was established by ultrasonographic examination of the affected hip followed by ultrasound-guided aspiration of the joint. Patients were allocated to have either open arthrotomy or arthroscopic drainage of the joint. There were ten patients (ten hips) in each treatment group. The mean age of the patients was 7.3 years in the arthrotomy group, and 8 years in the arthroscopy group. The mean temperatures for the arthrotomy and arthroscopy groups were 38.8 and 38.7 degrees C, respectively. All the children were unable to bear weight on the affected limb.
Staphylococcus aureus was the most common causative microorganism in both groups. The mean duration of the children's hospital stay was 6.4 days in the arthrotomy group and 3.8 days in the arthroscopy group. The difference was highly significant. Infection could be eradicated in all patients of both groups. At the latest follow-up, seven children in the arthrotomy group (70%) had excellent results and three children (30%) had good results. In the arthroscopy group, nine children (90%) had excellent results and one child (10%) had good results. The difference was not statistically significant.
Arthroscopic drainage is an effective method in treating septic arthritis of the hip. It is a minimal invasive procedure which is associated with less hospital stay. Arthroscopic drainage of septic arthritis of the hip in children is a valid alternative procedure in early uncomplicated cases and for orthopedic surgeons skilled in pediatric arthroscopy.
Preview · Article · Jul 2008 · Journal of Children s Orthopaedics