Related Experiment Video
Updated: Apr 23, 2026
Knee Arthrocentesis in Adults
Published on: February 25, 2022
[Arthroscopic therapy of septic hip infections in childhood]
F F Fernandez1, M Langendörfer, T Wirth
1Orthopädische Klinik, Klinikum Stuttgart, Olgahospital, Bismarckstr. 8, 70176, Stuttgart, Deutschland, f.fernandez@klinikum-stuttgart.de.
Insights
This study shows that two-portal hip arthroscopy is an effective minimally invasive treatment for septic arthritis in children, leading to excellent functional outcomes and hip development.
Area of Science:
- Pediatric Orthopedics
- Minimally Invasive Surgery
- Infectious Diseases
Background:
- Septic arthritis of the hip requires prompt diagnosis and effective treatment to ensure normal anatomical and functional development.
- Traditional treatments may involve open surgery, carrying higher risks and longer recovery times.
Purpose of the Study:
- To evaluate the efficacy and safety of two-portal hip arthroscopy for treating septic arthritis in children.
- To assess the impact of this minimally invasive approach on hip joint development and patient outcomes.
Main Methods:
- The study involved arthroscopic lavage of the hip joint using a two-portal technique.
- Procedures included debridement of osteomyelitis and placement of an antibiotic carrier if necessary.
- Patients were managed with a drain for 2-3 days followed by early mobilization.
Main Results:
- Two-portal hip arthroscopy is an efficient, minimally invasive method for treating hip septic arthritis, with or without femoral neck osteomyelitis.
- 19 out of 23 children were successfully treated with a single arthroscopic lavage.
- 22 out of 23 children achieved excellent Harris hip scores, with full return to activity.
Conclusions:
- Two-portal hip arthroscopy offers a safe and effective treatment for pediatric septic arthritis.
- This minimally invasive approach is associated with low morbidity and excellent functional recovery, promoting normal hip development.
Objective:
The treatment goal is to rapidly make a diagnosis and establish an effective arthroscopic therapy in order to allow the hip joint to develop normally throughout childhood with respect to anatomical and functional development.
Indications:
Coxarthritis suspected of being septic arthritis
Contraindications:
No experience with arthroscopy, osteomyelitis of the dorsal femoral neck requiring an intervention. Relative contraindication: absence of cannulated systems.
Surgical Technique:
Arthroscopic lavage of the hip joint, including revision of the femoral neck and debridement of osteomyelitis of the femoral neck with placement of an antibiotic carrier if necessary. The arthroscopy is performed using the two portal technique, placing the patient supine on a normal operation table (traction table not required).
Postoperative Management:
Drain for 2-3 days with mobilization after removal of the drainage. A second look arthroscopy is not normally planned but may become necessary in cases without improvement of the clinical or laboratory test parameters and after follow-up magnetic resonance imaging (MRI).
Results:
The two portal hip joint arthroscopy using an irrigation volume of 6-9 l is an efficient minimally invasive method to safely treat septic arthritis of the hip joint with or without concomitant femoral neck osteomyelitis. It is associated with low morbidity and offers all advantages of an arthroscopic procedure. Out of 23 children 19 could be sufficiently treated by a single arthroscopic lavage of the hip joint. In three patients an additional osseous component required a second intervention. Out of 23 children 22 achieved an excellent Harris hip score, with one girl only achieving a moderate outcome. The 22 children had an unrestricted hip function at follow-up and could return fully to previous activity levels.
