Simplified arthroscopic lavage of pediatric septic hip: case series

Septic arthritis of the pediatric hip is a surgical emergency that requires adequate lavage to decompress the hip, reduce degradative cartilage insult, and prevent coxarthrosis. In this report, we describe a simplified arthroscopic technique that may be performed using a single portal based on fluoroscopy and surface landmarks and without regular use of traction. We present results of a series of patients who underwent the simplified arthroscopic method for the management of pediatric septic hip. Data were obtained by a retrospective chart review of 13 consecutive patients (14 hips) with pediatric septic hip treated with arthroscopic lavage from 2010 to 2015. Age at the time of surgery ranged from 3 months to 8 years with three patients less than 1 year old. Ten hips (71%) returned for a routine follow-up with an average follow-up of 22 months. All 14 hips (100%) had complete resolution of symptoms. Two hips (14%) needed revision surgery due to inadequate response after the first lavage. One hip (7%) had transient femoral nerve palsy. Hip arthroscopy is an attractive and effective option for the management of pediatric septic hip. The limited equipment required and the ease of performing our simplified technique may broaden the application to the general orthopedist for the treatment of pediatric septic hip.