Clin Orthop Surg.  2020 Mar;12(1):94-99. 10.4055/cios.2020.12.1.94.

Functional Outcomes of Hip Arthroscopy for Pediatric and Adolescent Hip Disorders

• Lim C
• Cho TJ
• Shin CH
• Choi IH
• Yoo WJ

• KMID: 2470056
• DOI: http://doi.org/10.4055/cios.2020.12.1.94

Abstract

BACKGROUND
There is a paucity of literature on the use of hip arthroscopy for pathologic conditions in skeletally immature patients. Thus, the indications and safety of the procedure are still unclear. The purpose of this study was to investigate the safety and functional outcomes of hip arthroscopy for pediatric and adolescent hip disorders. We further attempted to characterize arthroscopic findings in each disease.
METHODS
We retrospectively reviewed 32 children and adolescents with hip disorders who underwent 34 hip arthroscopic procedures at a tertiary care children's hospital from January 2010 to December 2016. We evaluated functional limitations and improvement after operation by using the modified Harris hip score (HHS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), subjective pain assessment with a visual analog scale (VAS), and range of hip motion as well as the complications of hip arthroscopy. Arthroscopic findings in each disease were recorded.
RESULTS
Hip arthroscopy was performed for Legg-Calvé-Perthes disease (n = 6), developmental dysplasia of the hip (n = 6), slipped capital femoral epiphysis (n = 5), idiopathic femoroacetabular impingement (n = 6), sequelae of septic arthritis of the hip (n = 3), hereditary multiple exostosis (n = 2), synovial giant cell tumor (n = 3), idiopathic chondrolysis (n = 2), and posttraumatic osteonecrosis of the femoral head (n = 1). Overall, there was a significant improvement in the modified HHS, WOMAC, VAS, and range of hip motion. Symptom improvement was not observed for more than 18 months in four patients who had dysplastic acetabulum with a labral tear (n = 2) or a recurrent femoral head bump (n = 2). There were no complications except transient perineal numbness in five patients.
CONCLUSIONS
Our short-term follow-up evaluation shows that hip arthroscopy for pediatric and adolescent hip disorder is a less invasive and safe procedure. It appears to be effective in improving functional impairment caused by femoroacetabular impingement between the deformed femoral head and acetabulum or intra-articular focal problems in pediatric and adolescent hip disorders.

Keyword

Pediatric; Adolescent; Hip; Arthroscopy

MeSH Terms

Acetabulum
Adolescent*
Arthritis, Infectious
Arthroscopy*
Child
Exostoses, Multiple Hereditary
Femoracetabular Impingement
Follow-Up Studies
Giant Cell Tumors
Head
Hip*
Humans
Hypesthesia
Legg-Calve-Perthes Disease
Ontario
Osteoarthritis
Osteonecrosis
Pain Measurement
Retrospective Studies
Slipped Capital Femoral Epiphyses
Tears
Tertiary Healthcare
Visual Analog Scale

Figure

• 

  Fig. 1 A 15-year-old boy who underwent in situ screw fixation for mild to moderate slipped capital femoral epiphysis two years ago. A preoperative plain radiograph (A) showing decreased head-neck offset. Arthroscopic findings: torn labrum (B) and large femoral bump (C) impinging against the acetabular rim. Arthroscopic labral debridement (D) and osteochondroplasty (E) were performed. A postoperative plain radiograph (F) showing increased heckneck offset.

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