Background: This scoping review aimed to investigate the literature on the anatomy of the psoas valley, an anterior depression on the acetabular rim, and propose a unified definition of the anatomical structure, describe its dimensions, anatomical variations and clinical implications. Methods: A systematic computer search of EMBASE, PubMed and Cochrane for literature related to the psoas valley was undertaken using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Clinical outcome studies, prospective/retrospective case series, case reports and review articles that described the psoas valley and its synonyms were included. Studies on animals as well as book chapters were excluded. Results: Of the 313 articles, the filtered literature search identified 14 papers describing the psoas valley and its synonyms such as iliopsoas notch, a notch between anterior inferior iliac spine and the iliopubic eminence, Psoas-U and anterior wall depression. Most of these were cross-sectional studies that mainly analyzed normal skeletal hips. In terms of anatomical variation, 4 different configurations of the anterior acetabular rim have been identified and it was found that the curved type was the most frequent while the straight type may be nonexistent. Additionally, the psoas valley tended to be deeper in males as compared with females. Several papers established the psoas valley, or Psoas-U in a consistent location at approximately 3 o'clock on the acetabular rim which may have implications with labral pathology. Conclusion: This review highlights the importance of the anatomy of the psoas valley which is a consistent bony landmark. The anatomy and the anatomical variations of the psoas valley need to be well-appreciated by surgeons involved in the management of young adults with hip pathology and also joint replacement surgeons to ensure appropriate seating of the acetabular component.

Introduction: Delayed slip of the capital femoral epiphysis is a rare entity in the setting of a septic hip. Case Report: A 13-year-old male presented with an inability to walk and pain around right hip and knee region with fever. On imaging evaluation, a diagnosis of septic hip and knee arthritis was made and both the joints were drained under general anesthesia by anterior approach and an empirical antibiotic therapy was started. On the initial radiograph, there was no sign of slippage of the capital femoral epiphysis. Although the limb was kept in an immobilized position in the 1st week of the surgical debridement, yet it did not prevent the subsequent development of slipped capital femoral epiphysis (SCFE). Open reduction and screw fixation was done to stabilize the slippage. Healing took place with reduction of joint space with some restriction of the hip motion. Conclusion: SCFE is a disastrous complication in association with septic arthritis of a hip. Routine traction and immobilization may not prevent slippage. Disproportionate amount of pain on weight bearing in a post septic hip should raise the suspicion of SCFE. Prophylactic pinning may be considered in selective cases with antibiotic coverage. Keywords: Hip sepsis, septic sequelae, slipped capital femoral epiphysis.

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26 184 26.1 Arthroscopic Management of "Cam" Deformity Cam deformity treatment options include open surgical dislocation, direct anterior mini open approach, and arthroscopy [1-3]. The rates of good to excellent outcomes are comparable between open and arthroscopic techniques, although reported complications may be slightly less with arthroscopy [4-7]. The management of the femoral head-neck junction is one of the commonest arthroscopic hip procedures, and the 2018 UK Non Arthroplasty Hip Registry (http:// www.nahr.co.uk/) accounts for 89.4% of all femoral procedures performed. There are many published surgical variations of how to approach the cam in planning, portals, and use of fluoroscopy, and we believe as many anecdotal variations as the number of surgeons performing hip arthroscopy since every physician has their own tricks and routine [8-10]. We provide some basic principles where the surgeons can evolve their own routine (Table 26.1).