Hip Arthroscopy in Adolescents Through an Extra-Capsular Approach.

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics

Background:

• Hip arthroscopy is the gold standard for femoroacetabular impingement syndrome (FAIS) and labral tears in adults and adolescents.
• The conventional central compartment approach requires significant hip distraction, posing risks like neurovascular injury and avascular necrosis in adolescents.

Purpose of the Study:

• To describe an extracapsular hip approach as a potentially safer alternative for treating FAIS and labral tears in the pediatric and adolescent population.
• To highlight the advantages of the extracapsular approach in minimizing complications associated with hip distraction.

Main Methods:

• The study describes an extracapsular surgical technique for hip arthroscopy.
• This approach involves performing capsulotomy before hip distraction, allowing direct visualization of cam morphology.
• It utilizes smaller capsulotomies compared to the traditional central compartment approach.

Main Results:

• The extracapsular approach requires less hip distraction force, reducing the risk of iatrogenic injuries.
• This technique allows for early visualization of cam morphology without distraction.
• It is associated with a lower complication rate, making it more secure and simpler for adolescents.

Conclusions:

• The extracapsular hip approach presents a secure and effective alternative for arthroscopic treatment of FAIS and labral tears in pediatric and adolescent patients.
• This technique mitigates the risks inherent in significant hip distraction, offering a favorable safety profile.