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Review
. 2024 Apr 25:7:100064.
doi: 10.1016/j.jposna.2024.100064. eCollection 2024 May.

The evolving role and technique of hip arthroscopy in children and adolescents

Shalin Shah  1 , Tyler Stavinoha  2 , Jeffrey J Nepple  3 , Allison E Crepeau  4 ; PRiSM Hip RIG (Research Interest Group); Sasha Carsen  1
Affiliations
Review

The evolving role and technique of hip arthroscopy in children and adolescents

Shalin Shah et al. J Pediatr Soc North Am. .

Erratum in

Abstract

Hip Arthroscopy in the pediatric and adolescent hip has evolved from its role as a diagnostic tool to a primary modality of management of variety of hip pathologies in children and adolescents. This article reviews current concepts and advances in hip arthroscopy in this population. We discuss the indications, techniques, outcomes, and complications of hip arthroscopy in children and adolescents. We explore the newer indications of hip arthroscopy in the treatment of SCFE (Slipped Capital Femoral Epiphysis) deformity correction, borderline hip dysplasia, septic arthritis, infantile developmental dysplasia, Perthes disease, and the existing and developing evidence. Finally, we address the challenges and future directions in research, education, and training, unique to the pediatric and adolescent population.

Key concepts: (1)Hip arthroscopy has significant surgical applications in the pediatric and adolescent population, and can be used to help address several intra-articular as well as extra-articular pathologies.(2)The indications and potential for arthroscopic interventions and associated arthroscopic techniques is growing and developing rapidly, along with improving technology, techniques, and training.(3)FAI (Femoro Acetabular Impingement) and labral pathology are the most common indications for surgery in the adolescent, and clinical outcome studies show excellent results. However, nonoperative optimization should be strongly emphasized before surgical consideration.(4)Hip arthroscopy is minimally invasive and relatively low risk, though main risks and complications to be aware of is the potential need for revision or further surgery, transient neuropraxia of the pudendal nerve, surgical site infection, implant/tool-related breakage or failure, failed surgery, and venous thromboembolism.(5)Continued research and innovation in the field of pediatric hip arthroscopy are essential for further improving outcomes and expanding treatment options for young patients with hip disorders, and more pediatric-specific clinical research is needed.

Keywords: Adolescent hip; Femoroacetabular impingement; Hip arthroscopy; Labral tear; Pediatric hip.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Sasha Carsen reports a relationship with Stryker Sports Medicine that includes: speaking and lecture fees. Sasha Carsen reports a relationship with Smith and Nephew Inc that includes: speaking and lecture fees. Jeffrey J. Nepple reports a relationship with Smith and Nephew Inc that includes consulting, speaking and lecture fees. Jeffrey J. Nepple reports a relationship with Arthrex that includes consulting, speaking and lecture fees. Jeffrey J. Nepple reports a relationship with Responsive Arthroscopy which includes royalties. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1
Figure 1
Shows the typical room setup for a case of hip arthroscopy.
Figure 2
Figure 2
Portals routinely used in hip arthroscopy. A, anterior; AL, anterolateral; DALA, distal anterolateral; MA, mid-anterior.
See this image and copyright information in PMC

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