Indications for hip arthroscopy in pediatric patients a systematic review

Awad, Moayd; Bajwa, A.; Slaunwhite, Erin; Logan, Karl; Wong, Ivan

doi:10.1093/jhps/hnz056

Cited by 12 publications

(10 citation statements)

References 44 publications

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“…Hip arthroscopy in the pediatric population is known to be a particularly challenging procedure, mainly due to anatomical variation in the skeletally immature patient. 2,8,37 A significant decrease in the neck-shaft angle and anteversion must be kept in mind when positioning the patient and care must be taken to respect the open physes. Additionally, due to the immaturity of the acetabulum, theoretical risks of slipped capital femoral epiphysis (SCFE), avascular necrosis, and infection do exist.…”

Section: Discussionmentioning

confidence: 99%

Rate of Revision Hip Arthroscopy for Pediatric Femoroacetabular Impingement: A Systematic Review

Mojica¹,

Yedikian²,

DeClouette³

et al. 2022

The Journal of Hip Surgery

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Femoroacetabular impingement (FAI) can cause pain, dysfunction, and early arthritic progression in young patients. The purpose of this study was to systematically review the evidence in literature to determine patient-reported outcomes and failure rates as defined by the need for revision surgery, following hip arthroscopy for pediatric patients with FAI. The literature search was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Clinical studies evaluating the outcomes following primary hip arthroscopy for pediatric patients with FAI were included. Clinical outcomes evaluated included revisions, complications, functional outcome scores (modified Hip Harris Score [mHHS], Non-Arthritis Hip Score, and Visual Analogue Score), and return to play. Statistical analysis was performed using GraphPad Prism version 7. This study is a level IV systematic review. Overall, 20 clinical studies with 1,136 patients (1,223 hips) were included in this review, with an average age of 16.3 years. Overall, 8.6% patients experienced revision surgery. The mHHS was the most widely used metric, present in 17 of the 20 studies. The mHHS was reported as excellent (> 90) in six of these studies and good (80–89) in 11. The weighted mean of the post-operative mHHS found across reporting studies was 84.3, from a baseline score of 58.1. The overall return to play rate was 91%. This study reports excellent post-hip arthroscopy clinical outcomes for FAI and labral tears in the pediatric population. However, revision rates for this surgical procedure are higher than previously documented.

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Section: Discussionmentioning

confidence: 99%

Rate of Revision Hip Arthroscopy for Pediatric Femoroacetabular Impingement: A Systematic Review

Mojica¹,

Yedikian²,

DeClouette³

et al. 2022

The Journal of Hip Surgery

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“…There is a paucity of scientific evidence regarding the role of arthroscopy in LCPD. Several studies have shown that arthroscopy improves function in LCPD patients and has multiple advantages over open hip surgery including smaller incisions, a shorter recovery period, reduced damage to already damaged articular cartilage, and reduced risk of avascular necrosis of femoral head 3 4) . There is no synthesis of information in the form of a systematic review on indications and outcomes of hip arthroscopy in sequelae of LCPD, therefore the aim of the current study is to evaluate existing literature regarding the role and outcomes of hip arthroscopy in LCPD.…”

Section: Introductionmentioning

confidence: 99%

Hip Arthroscopy for Sequelae of Legg-Calve-Perthes Disease: A Systematic Review

2021

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There is no clear evidence on indications and outcomes of hip arthroscopy in sequelae of Legg-Calve-Perthes disease (LCPD). The aim of the current study was to evaluate current literature on the role and outcome of hip arthroscopy in LCPD. A literature search using four databases was conducted in April 2020, focusing on the role of hip arthroscopy in sequelae of LCPD. A systematic search was carried out in confirmation with the Cochrane Collaboration, Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of nine studies were included in the systematic review. The total number of hip arthroscopies performed for LCPD was 109. The mean age of included patients was 34.8±7.88 years (7–58 years). Recalcitrant hip pain was the main indication for surgery, followed by pain and stiffness. The most common finding in arthroscopy was labral tears, followed by osteochondral lesions of femoral head or acetabulum and intra-articular loose bodies. Consequently, debridement of labrum tears chondroplasty for cartilage defects and osteoplasty for impingement from deformed femoral head (hinged abduction) were commonly performed. A significant improvement in hip function was seen in all studies. Pooled data of Harris hip score showed significant improvement after surgery was conducted. Hip arthroscopy may be beneficial in patients having symptoms of impingement secondary to changes in labrum, femoral head or acetabulum. Limited evidence shows improved function and range of motion after surgery. This treatment has been found to be safe in terms of complication rates and improvement may persist for years.

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“…Arthroscopic labral repair and osteochondroplasty are options for correcting intra-articular abnormalities [ 5 ]. Indications for arthroscopy for LCPD include recalcitrant hip pain, intra-articular pathology including loose bodies, labral tears and cartilage lesions [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Simultaneous Morscher’s osteotomy and arthroscopic debridement in the management of Legg–Calvé–Perthes disease: a case report and literature review

Bosakhar

Baldawi

Liu

et al. 2021

Journal of Hip Preservation Surgery

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There is a lack of consensus around optimal surgical management for Legg–Calvé–Perthes Disease (LCPD). This case report discusses the benefits of combining arthroscopic femoral neck osteochondroplasty and labral repair with Morscher’s Osteotomy (MO) for LCPD. S.A. is a 17-year-old female diagnosed with LCPD at the age of 6 years and has long-standing right hip symptoms. An arthroscopic femoral neck osteochondroplasty and labral repair followed by MO was performed. The pre-operative and 8 months post-operative International Hip Outcome Tool (iHOT-12) scores were 16.3 and 79.8 out of 100, respectively, indicating better quality-of-life. Also, the femoral neck-shaft-angle (NSA) changed from 120 pre-operative to 138.7 post-operative to represent the correction of coxa vara. The literature review revealed no published reports describing combined MO with hip arthroscopic interventions in managing LCPD. Combined arthroscopic femoral neck osteochondroplasty (with labral repair) and MO provides high patient satisfaction and improves radiographic parameters in patients with LCPD.

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Indications for hip arthroscopy in pediatric patients a systematic review

Cited by 12 publications

References 44 publications

Rate of Revision Hip Arthroscopy for Pediatric Femoroacetabular Impingement: A Systematic Review

Rate of Revision Hip Arthroscopy for Pediatric Femoroacetabular Impingement: A Systematic Review

Hip Arthroscopy for Sequelae of Legg-Calve-Perthes Disease: A Systematic Review

Simultaneous Morscher’s osteotomy and arthroscopic debridement in the management of Legg–Calvé–Perthes disease: a case report and literature review

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