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Arthroscopy for hip septic arthritis in children
I Sanpera1, D Raluy-Collado1, J Sanpera-Iglesias1
1Pediatric Orthopedic Department, Hospital Universitari Son Espasses, Palma de Mallorca, Spain.
Insights
Hip arthroscopy is a safe and effective treatment for pediatric septic arthritis, maintaining excellent long-term clinical outcomes. This minimally invasive approach offers a viable alternative to hip aspiration for young patients.
Area of Science:
- Pediatric Orthopedics
- Minimally Invasive Surgery
- Infectious Diseases
Background:
- Septic arthritis of the hip (HSA) in children can lead to long-term joint damage.
- Previous studies show good short-term outcomes for hip arthroscopy in HSA treatment.
- Long-term efficacy of hip arthroscopy for pediatric HSA requires further evaluation.
Purpose of the Study:
- To assess the long-term clinical and radiological outcomes of hip arthroscopy for treating septic arthritis in children.
- To compare the effectiveness of arthroscopic drainage versus traditional hip aspiration for HSA.
Main Methods:
- Retrospective analysis of 12 pediatric patients diagnosed with HSA (median age 6 years).
- All patients underwent arthroscopic drainage, with hip joint distension used for younger children.
- Outcomes were evaluated using the Hip Harris Score (HHS) and radiographic studies.
Main Results:
- Excellent clinical results were achieved in all but one patient, with outcomes sustained long-term.
- Two patients required repeat arthroscopy; two showed radiological changes.
- Late presentation for treatment was associated with poorer outcomes.
Conclusions:
- Hip arthroscopy is a feasible and effective treatment for pediatric hip septic arthritis, even in the youngest patients.
- The positive clinical results achieved with arthroscopy are maintained over time.
- Early diagnosis and treatment are crucial for optimal outcomes in pediatric HSA.
Background:
Hip arthroscopy for treatment of septic arthritis in children has previously been reported with excellent short-term results. The purpose of this study was to evaluate the long-term results of hip arthroscopy for hip septic arthritis (HSA) in paediatric patients.
Hypothesis:
Arthroscopy still is a useful tool in the treatment of HSA, and may be superior to simple hip aspiration.
Materials And Methods:
Twelve patients with a median age of 6 years, with community-acquired infections, were diagnosed as HSA. All of them were treated using arthroscopic drainage. The duration of symptoms at presentation were a median of 3,5 days (2-20). In the younger patients (<8 years), hip joint distension was used instead of hip traction. At final check-up, the Hip Harris Score (HHS) was used and a radiographic study done.
Results:
Two patients required a repeat arthroscopy. All, except for one patient, achieved excellent clinical results. Two patients presented radiological changes at the last check-up. The poor results were related to late presentation for medical treatment. There was no difference between early and late results.
Discussion:
Hip arthroscopy for child HSA is a feasible technique even for the youngest patients, moreover the positive clinical results initially obtained are maintained over time.
Level Of Evidence:
Level IV: retrospective series.
