Beverly J. Stickles, Brett D. Owens, and Brian D. Busconi
Hip arthroscopy has obvious advantages over arthrotomy in the pediatric population. Whether hip arthroscopy is performed as a diagnostic or therapeutic intervention, it is significantly less invasive than arthrotomy and therefore allows for early recovery and return to activities. Furthermore, arthroscopy does not place the child at risk for avascular necrosis by dislocating the femoral head. Hip arthroscopy is still a technically demanding procedure in the pediatric population, but is easier to perform than in adults due to a relatively shallow joint with compliant soft tissues.1
Indications for hip arthroscopy in pediatric patients were first introduced into the orthopedic literature in 1977 by Richard Gross.2 A few years later, Holgerrson et al performed 15 hip arthroscopies in pediatric patients with juvenile rheumatoid arthritis. The arthroscopies allowed inspection of joint surfaces and more information about synovitis than plain radiographs provided, as well as an opportunity for synovec-tomy.3 Current indications for pediatric hip arthroscopy include septic arthritis, labral pathology, slipped capital femoral epiphysis, and Legg-Calve-Perthes disease. The role of hip arthroscopy in the pediatric population has not been thoroughly defined in the orthopedic literature. Due to the attractiveness of a less invasive option for pediatric patients, the indications for hip arthroscopy will no doubt expand.
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