Arthroscopic techniques in management of pediatric hip conditions have now been explored for treatment of DDH hips as well. Eberhardt et al from Olgahospital Stuttgart, Germany, presented their early experience of arthroscopic reduction of the dislocated hip in very young infants with developmental dysplasia of the hip (DDH).
Eight dislocated hips in five children with failed attempts at closed reduction were treated by arthroscopy of the hip with a mean age of 5.8 months (4 to 7). All hips were reduced by a single arthroscopic procedure, the reduction being confirmed on MRI scan.
At a mean follow-up of 13.2 months (9 to 24), all eight hips remained stable although three hips showed some evidence of avascular necrosis. Acetabular index improved notably in all cases.
Comments:
Arthroscopic or arthroscopy-assisted procedures in pediatric joints are certainly gaining ground. This article outlines the feasibility of using arthroscopy of the hip for hip reduction in infants with DDH and dislocated hips. It is important to note that there is a learning curve involved and even in good hands the medial portal can cause inadvertent damage to the MCFA (main blood vessel supplying blood to the femoral head) and can lead to avascular necrosis of the femoral head.
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