Current Reviews in Musculoskeletal Medicine (2023) 16:284–294

https://doi.org/10.1007/s12178-023-09842-2

Pediatric Hip Arthroscopy: a Review of Indications and Treatment

Outcomes
Helen Crofts1 · Mark McConkey1,2,3 · Parth Lodhia1,2,4

Accepted: 24 April 2023 / Published online: 31 May 2023

© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023

Abstract
Purpose of Review The use of hip arthroscopy has expanded substantially over the last decade, including in pediatric and
adolescent populations. Indications for hip arthroscopy in the pediatric population continue to be refined and research of
outcomes following hip arthroscopy has increased. The purpose of this review is to provide an overview of current indica-
tions for hip arthroscopy in the pediatric population and the outcomes for each indication.
Recent Findings Hip arthroscopy is used in the treatment of a range of pediatric hip conditions, spanning from the infant to
young adult. In femoroacetabular impingement, hip arthroscopy in young adolescents has shown improvement in patient-
reported outcome measures, high return to sport rates, and low complications. Intra-articular hip pathology secondary to
Legg-Calve-Perthes and the persistent deformities following slipped capital femoral epiphysis can be managed with primary
hip arthroscopy, and outcomes show significant improvements in patient-reported outcomes. Arthroscopy can be used safely
as a reduction aid in developmental hip dysplasia, and as a primary treatment for borderline hip dysplasia in adolescents. In
septic hip arthritis, arthroscopic drainage is a safe and effective treatment.
Summary Hip arthroscopy is used in the pediatric and adolescent population in the management of femoroacetabular
impingement, Legg-Calve-Perthes disease, the sequelae of slipped capital femoral epiphysies, developmental hip dysplasia,
and septic arthritis. Research for each of these conditions shows that arthroscopy is a safe and effective treatment when
performed for the correct indications, and results are comparable to open surgical options.

Keywords Hip arthroscopy · Pediatric · Adolescent · Femoroacetabular impingement

Introduction shorter operative times, shorter hospital stays, and better

visualization of intra-articular anatomy [65••, 84].
The indications for hip arthroscopy continue to be refined Conditions of the hip in pediatrics are common and include
and the use of the procedure continues to grow [83]. Poten- the spectrum of developmental dysplasia, septic arthritis,
tial benefits over open procedures include less invasiveness, Legg-Calve-Perthes disease (LCPD), slipped capital femo-
ral epiphysis (SCFE), femoroacetabular impingement (FAI),
* Parth Lodhia juvenile arthritis, and trauma. Early use of hip arthroscopy in
parth.lodhia@ubc.ca pediatric patients was reported by Gross for developmental
Helen Crofts dysplasia, septic arthritis, LCPD, and SCFE [85]. Other early
h.crofts@alumni.ubc.ca uses of arthroscopy included the treatment of osteochondral
Mark McConkey lesions resulting from SCFE and juvenile arthritis [86, 87].
mark_mcconkey@hotmail.com Although the literature is not as robust as in the adult popula-
tion, there has been increased interest in the use of arthros-
1
Department of Orthopaedics, University of British copy as the primary treatment of multiple pediatric hip condi-
Columbia, Vancouver, Canada
tions and as an adjunct to address intra-articular pathology.
2
Vancouver Hip Institute, Vancouver, Canada Outcome reporting has increased, with good short to mid-
3
Pacific Orthopedics and Sports Medicine, North Vancouver, term results for a range of indications. This review provides
Canada an overview of hip arthroscopy in the pediatric and adolescent
4
Fraser Orthopaedic Institute, population with a focus on indications and outcomes.
Nelson’s Crescent, New Westminster, BC 403‑233, Canada

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Current Reviews in Musculoskeletal Medicine (2023) 16:284–294
Patient Evaluation
Clinical evaluation starts with taking a thorough history.
Identifying the chief complaint, the duration, and onset
of symptoms, and evaluating for any history of trauma are
important starting points. A history of any known previous
pediatric hip conditions should be elicited. Evaluation of
whether the pain is from intra-articular or extra-articular
pathology aids diagnosis. Intra-articular pathology typically
presents with anterior hip or groin pain and may radiate to
the knee [78]. Mechanical symptoms, such as snapping
or catching, can suggest either an intra-articular or extra-
articular pathology [78]. Precipitating factors, sports history,
overall medical history, and any attempted treatments should
be included.
Physical examination is similar to adults in patients over
12 years of age [78]. Assess the gait (Trendelenburg or
ataxic) and weight bearing status. Observe the position of
the leg and evaluate for leg length discrepancy. Record hip
range of motion, starting with the normal limb, in flexion,
extension, abduction, adduction, and internal and exter-
nal rotation. Obligate external rotation with flexion of the
hip may be seen in FAI and SCFE [78]. Decreased inter-
nal rotation may indicate intra-articular pathology. FAD-
DIR (flexion, adduction, internal rotation) is a provocative
test for impingement. FABER (flexion, abduction, external
rotation), Thomas, Scour, and posterior impingement tests
should be performed. Examination of the spine and knee,
plus a detailed neurologic exam, helps identify other poten-
tial causes of hip pain or gait disturbance.
Imaging
Radiographs including anterior–posterior (AP) and frog leg
lateral views are a starting point for many diagnoses and
no further imaging may be required. Specific views when
assessing for femoroacetabular impingement (FAI) include
Fig. 1  Modified Dunn views
of an adolescent male with
femoroacetabular impinge-
ment. A Pre-operative images
demonstrating cam morphology
and B post-operative images
after femoral osteochondro-
plasty with resection of cam
morphology
285
the modified Dunn lateral [45 degrees flexion] (Fig. 1) and
false-profile view of Lequesne and de Seze (78). In very
young patients, ultrasound for developmental hip dyspla-
sia is the primary modality. Ultrasound is also useful in the
diagnosis of septic arthritis for evaluation of joint effusion
and potential aspiration. The benefits of computed tomog-
raphy (CT) scan should be balanced with risk of radiation.
CT provides more details on bony anatomy than radiographs
and is frequently used in FAI and DDH evaluation. Magnetic
resonance imaging (MRI) provides the most detail about soft
tissue and intra-articular anatomy. In young patients where
cumulative radiation dosing is a concern, it is especially
important. Recent evidence suggests three dimensional (3D)
MRI can be used to evaluate osseous morphology in FAI
and could replace the need for 3D CT scans, which would
be especially beneficial in young patients [79].
Technique
Hip arthroscopy can be performed in the supine or lateral
position. Supine positioning on a fracture table without a
perineal post is the preferred technique of the authors [89].
In very young children, they may be positioned on a radio-
lucent table without a post and the surgical assistant can
provide gentle traction on the leg as needed [81, 82•]. Por-
tals are established under fluoroscopic guidance, starting
with the anterolateral portal [80]. The mid-anterior portal is
established under direct visualization. Standard hip arthros-
copy equipment can be used in adolescents and older chil-
dren. In younger and small children, a specific 2.7-mm mini-
hip arthroscope may be required [81]. After an interportal
capsulotomy is performed with an arthroscopic blade or
radiofrequency wand, a diagnostic arthroscopy is performed
evaluating the labrum, status of ligamentum teres, articular
cartilage, and the presence of cam or pincer morphology
(Fig. 2). Further management depends on the indication for
which the arthroscopy is being performed. Post-operative
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care will be dictated by the procedure performed and may
involve spica casting in the case of reduction of a dislo-
cated hip in dysplasia, use of a drain in septic arthritis, or a
period of non-weight bearing and crutches for treatment of
impingement. Early hip range of motion and physiotherapy
is an important part of recovery.
Specific Indications
Femoroacetabular Impingement
Assessment and Diagnosis
Femoroacetabular impingement (FAI) is a common cause
of hip pain and limited sports participation in adolescents.
Multiple studies have shown that cam morphology is a risk
factor for development of hip osteoarthritis [88]. Diagno-
sis is based on symptoms, clinical findings, and imaging
demonstrating early contact between the femoral head and
acetabulum during hip motion [2]. Asymmetric hip pain,
decreased hip range of motion, activity-related pain, and
mechanical symptoms are all suggestive of FAI. On exami-
nation, there may be obligate external rotation with hip flex-
ion and positive impingement signs. Imaging includes stand-
ard AP and lateral radiographs with additional Dunn and
false-profile views. MRI arthrogram is helpful for evaluating
Fig. 2  Arthroscopic intra-oper-
ative images of an adolescent
male left hip with femoroac-
etabular impingement showing
A a labral tear pre and B post
repair in addition to C cam
morphology and D post femoro-
plasty of cam morphology
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Current Reviews in Musculoskeletal Medicine (2023) 16:284–294
intra-articular pathology such as labral tears and osteochon-
dral defects.
Development of FAI
FAI may develop in adolescents secondary to SCFE, or
iatrogenically after periacetabular osteotomy for develop-
mental hip dysplasia [5–7]. Overgrowth of the femoral capi-
tal epiphysis not related to other hip pathology likely con-
tributes to the majority of FAI and there is growing evidence
to suggest that young athletes are at risk for development of
cam-type deformities [8•, 9, 10]. Adolescent male basketball
players compared to age-matched controls had higher alpha
angles during and after closure of the proximal femur physis
on MRI [11]. A systematic review and meta-analysis found
male adolescent athletes to be at 1.9–8 times increased risk
of developing cam morphology by skeletal maturity [12].
The sports at highest risk of developing cam morphology
were basketball and hockey [12]. Adolescent soccer players
also appear to have higher prevalence of cam morphology
compared to non-athlete controls [9, 13, 14]. In adolescent
male athletes, cam morphology appears to develop prior to
closure of the proximal femoral physis particularly at the
time of peak growth velocity, with evidence supporting a
dose–response relationship with involvement in sports activ-
ity [8•, 15, 19]. Repetitive mechanical loading on an open
physis during growth leading to epiphyseal hypertrophy
Current Reviews in Musculoskeletal Medicine (2023) 16:284–294
has been proposed as an explanation for cam development
[16, 17]. Prospective and cohort studies of adolescent ath-
letes show that cam morphology primarily develops during
growth starting at 12–14 years of age [17, 18]. Despite evi-
dence that male athletes participating in specific sports are at
higher risk of developing cam morphology, there is no clear
understanding as to who will go on to become symptomatic
and therefore it is difficult to recommend activity modifica-
tions or specific physical therapy as preventative measures
[17]. Despite numerous studies of male adolescent athletes,
there is minimal research investigating the development of
FAI in females. In a study of the prevalence of cam-type
deformity in professional women hockey players, there was
a positive correlation between age of menarche and alpha
angle [20]. In a retrospective review of female adolescent
single sport athletes with a diagnosis of FAI, athletes par-
ticipating in running, soccer, and hockey had significantly
higher alpha angle than dancers [21]. Further research is
needed to clarify the development and risk factors of FAI
in female adolescent athletes. Pincer morphology on the
acetabulum was not associated with sport participation dur-
ing adolescence in a cohort of male and female athletes [19].
Treatment and Outcomes
Treatment of FAI in adults with hip arthroscopy has shown
good mid- to long-term results and the use in pediatric FAI
is increasing [3, 4]. Physiotherapy continues to be first-line
treatment, with those failing non-operative management
being considered for hip arthroscopy. Surgical management
is based on individual pathology with femoroplasty for cam
morphology, acetabuloplasty for pincer morphology, and
repair or debridement of labral tears. Timing of surgery is
controversial, although is usually delayed until closure of the
proximal femoral physis to avoid damaging the growth plate.
In adolescent patients with open physes undergoing hip
arthroscopy for FAI, there is a theoretical risk of recurrence
and growth restriction [23]. In patients with an open physis
and communication of the cam morphology with the physis,
it has been suggested to stage the procedure and address the
cam morphology after growth plate closure [22]. In adoles-
cents undergoing arthroscopy for FAI with a physis-sparing
approach, there were significant sustained improvements in
mHHS, HOS-ADL, and HOS-SSS 8.9 years post-operatively
and the improvements were greater than in a matched adult
cohort [39•]. In non-physeal-sparing femoral osteochondro-
plasty, ablation of the anterolateral physis during cam resec-
tion was utilized by Larson et al. to avoid recurrence, with
good radiographic measurements and functional outcome
scores and no deformity recurrence at 1 year post-op [23].
Although evidence is limited, other studies of hip arthros-
copy for FAI in skeletally immature patients have not shown
any avascular necrosis, growth restriction, or high levels of
287
deformity recurrence [24, 25]. Outcomes after hip arthros-
copy for FAI in adolescents have shown improved post-
operative patient-reported outcome measures (PROMs), low
revision rates (2–5%), low complication rates, and high rates
of return to sport (84.9%) [26, 27]. In addition to PROMs,
minimal clinically important differences (MCID) and patient
acceptable symptom states (PASS) are met with high rates
in the pediatric population up to 5-year follow-up [28••, 29,
30••]. As FAI is seen at higher rates in the athletic popula-
tion, return to sport is an important indication of surgical
success. Numerous studies have found high rates of return
to sport after hip arthroscopy in the adolescent population
(78.1–93%) [25, 31•]. Long-term studies are needed to
investigate the rates of osteoarthritis and conversion to total
hip arthroplasty in the adolescent population undergoing hip
arthroscopy for FAI.
Legg‑Calve‑Perthes Disease
Assessment and Diagnosis
Legg-Calve-Perthes disease (LCPD) is a self-limiting pro-
cess that develops as a result of ischemia in the capital femo-
ral epiphysis of pediatric patients [35]. Initial diagnosis is
made by clinical presentation and hip radiographs. As the
fragmentation stage resolves, and re-ossification and remod-
eling occur, mechanical hip pain may develop secondary to
loose bodies, labral tears, or impingement from a misshapen
femoral head. MRI is useful in identifying intra-articular hip
pathology and should be performed in those with persistent
hip pain after a trial of conservative treatment, although it
may not identify the full extent of the pathology that can be
seen on arthroscopy [35].
Indications and Treatment Outcomes
In many patients, LCPD is well managed non-operatively
with restricted weight bearing, analgesics, and physiother-
apy, resulting in excellent results and preserved hip range of
motion. Hip arthroscopy is indicated in patients who develop
painful hips with mechanical symptoms after the resolution
of active LCPD. Intra-articular findings seen as a sequelae
of LCPD that can be addressed with arthroscopy include
labral tears, osteochondritis dissecans, and ligamentum teres
tears [32, 33]. Although there is limited published literature
on hip arthroscopy for the treatment of sequelae of LCPD,
initial results show improvement in hip function. At 2-year
follow-up, Lee et al. found improved hip range of motion,
VAS, and mHHS scores in a retrospective review of patients
with late-stage sequelae of LCPD (p < 0.001) at a mean age
of 26.4 years [36]. In six patients with late-stage LCPD
and mean age of 15.2 years undergoing arthroscopy, there
was improved hip function and symptoms after undergoing
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debridement, loose body removal, and osteochondroplasty
[37]. In a systematic review and meta-analysis of hip
arthroscopy for LCPD, there was a significant improvement
in post-operative mHHS [38]. Specific technical challenges
to arthroscopy with prior LCPD include navigating hyper-
trophy of the greater trochanter, coxa magna, and acetabular
changes [33].
Borderline Developmental Dysplasia of the Hip
Assessment and Diagnosis
Developmental dysplasia of the hip (DDH) is a challenging
problem to manage surgically throughout a patient’s life. As
adolescents and adults, under coverage of the femoral head
by the acetabulum can result in impingement on the labrum
and micro-instability, and is a risk factor for developing oste-
oarthritis [40, 41]. Borderline DDH (BDDH) is defined as
a lateral center–edge angle (LCEA) of 20–25 degrees [42].
Patients typically present with hip pain of insidious onset,
although acute onset after a traumatic event is possible, and
with functional impairment plus mechanical symptoms [43].
The LCEA is measured from the AP hip radiograph. MRI
or MR arthrogram is a useful adjunct to evaluate for labral
tears and intra-articular pathology [42].
Indications and Treatment Outcomes
Arthroscopy alone in the management of symptomatic
borderline DDH has positive results in the adolescent
population but is not recommended in patients with an
LCEA < 18–20 degrees. Two systematic reviews have eval-
uated the PROMs of patients treated with arthroscopy for
BDDH, all finding significant improvements in the mHHS
and high rates of achieving the MCID (79.5%) for the mHHS
[44, 45]. Meta-analysis by Krivicich et al. found patients
with BDDH had non-inferior outcomes for multiple PROMs
compared to control subjects without dysplasia, further sup-
porting arthroscopy as a treatment for patients with symp-
tomatic BDDH [46•]. Many studies included in the system-
atic reviews include patients less than 18 years old in their
cohorts, but there are very few studies specifically looking at
arthroscopy for BDDH in adolescents. Evans et al. compared
adolescent patients, mean age 15.5 years, undergoing pri-
mary arthroscopy with BDDH to a control group and found
significant improvements in mHHS, HOS-ADL, HOS-SS,
and NAHS at 2 years post-operatively [43]. All patients in
this study underwent capsular plication and epiphyseal clo-
sure (43). There were no revisions or conversions to total
hip arthroplasty (THA) within the 2-year follow-up window
[43]. This study supports hip arthroscopy as a viable option
for mechanical pain in BDDH patients, with low rates of
conversion to THA at least in the short term.
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Current Reviews in Musculoskeletal Medicine (2023) 16:284–294
For patients with an LCEA < 20 degrees, periacetabular
osteotomy (PAO) is often recommended. The use of arthros-
copy as an adjunct to PAO to address intra-articular pathology
is increasing and can be done in a combined or staged fashion.
These procedures are done once growth has stopped, typically
in the late adolescent to young adult ages when symptoms
develop prior to the onset of arthritis. Although PAO alone
shows good results in terms of functional outcome and PROMs
improvements, intra-articular lesions that are a risk factor for
progression of osteoarthritis are not addressed without addi-
tion of arthroscopy or open arthrotomy [51, 52]. Up to 59%
of patients undergoing PAO for dysplasia have chondrolabral
injuries [47]. In concomitant arthroscopy and PAO, the arthros-
copy is completed first to address any intra-articular pathol-
ogy or cam morphology with capsular closure. This has shown
good results in terms of improvement in PROMs, high return
to sport, comparable revision rates, and no increased compli-
cations compared to PAO alone [48, 49•, 50•, 54•]. Staging
arthroscopy to be done at an earlier surgical date than the PAO
is an emerging concept. In a comparison between staged ver-
sus combined hip arthroscopy and PAO, Orner et al. found no
differences in the outcomes at 12 months post-op and signifi-
cantly improved PROMs from pre- to post-op for both groups
[53]. The authors propose that a benefit of staging would be
the arthroscopy could inform operative decision-making for the
PAO, including canceling surgery if the chondral defects were
sufficiently advanced to be a contraindication for PAO [53].
Arthroscopic‑Assisted Reduction in Developmental
Dysplasia
Assessment and Diagnosis
Ultrasound screening for DDH has significantly reduced
the need for surgical management and the likelihood of late
presentation [55]. In infants with developmental hip dyspla-
sia and failure of treatment with a Pavlik harness, there are
several potential blocks to a closed reduction. Obstacles to
reduction in dislocated hips include a hypertrophied liga-
mentum teres and transverse ligament, a constricted capsule,
or the pulvinar [57].
Indications and Treatment Outcomes
In patients with DDH and failed closed reduction, surgical man-
agement is indicated. Traditionally open reduction through a
medial or anterior approach has been used. The major concern
with open reduction is the risk of avascular necrosis (AVN), with
a systematic review finding an overall AVN rate after medial
open reduction to be 20% [56]. Arthroscopic-assisted reduc-
tion has been used as an alternative to traditional open reduc-
tion. The majority of studies are small retrospective case series
with 3 to 40 patients [57–61, 63]. All studies showed successful
Current Reviews in Musculoskeletal Medicine (2023) 16:284–294
reduction in 80–100% of cases, with capsule constriction, hyper-
trophied ligamentum teres, and transverse ligament being the
most common reason for a block to reduction and requiring
release [57–61, 63]. The rate of AVN was reported from 0% at
60-month follow-up, to 38% at 13.2-month follow-up [57, 58].
In a comparison of patients treated with open medial reduc-
tion versus arthroscopic reduction, there were no differences
in acetabular index 26 degrees in both groups or rate of AVN
[62••]. These results are comparable to those reported for open
reduction and further studies plus longer term follow-up will
help determine if there are any clear differences in the outcome
between arthroscopic and open reduction.
Septic Arthritis
Assessment and Diagnosis
Septic arthritis of the hip in pediatrics requires urgent diag-
nosis and treatment to prevent long-term sequelae. Present-
ing symptoms include inability to weight bear, dysfunction
and pain in the hip, fever, and malaise [64]. Laboratory
studies showing an elevated white blood cell count, CRP,
ESR and blood cultures aid in the diagnosis [64]. Ultrasound
and MRI imaging can identify an effusion and support the
diagnosis [64]. Arthrocentesis of synovial fluid with positive
cultures and cell count demonstrating a WBC of > 50,000/
mm3 and > 75% polymorphonuclear neutrophils is diagnostic
[64].
Indications and Treatment
Once septic arthritis of the hip is diagnosed, treatment with
arthrocentesis, arthroscopy, or arthrotomy is required to drain
and irrigate the joint. Destruction of the articular surface can
begin within 8 hours of inoculation and increased intracapsu-
lar pressure may lead to ischemia and avascular necrosis [64].
Arthroscopy has emerged as an alternative to open arthrot-
omy in the treatment of septic hip arthritis in pediatrics. In a
prospective controlled study investigating arthrotomy versus
arthroscopy for septic hip arthritis, El-Sayed found all infec-
tions were successfully treated in each group and there were
no difference in the outcomes following surgery [65••]. There
were significant differences in the length of hospital stay, with
patients treated with arthroscopy having an earlier discharge
(3.8 versus 6.4 days) [65••]. In a large retrospective database
review, there was no difference in the return to operating room
or short-term complications at 30 days between arthrotomy
and arthroscopy [65••]. In a systematic review of drainage
techniques for pediatric septic hip arthritis, patients treated
with arthroscopy without a drain required a repeat drainage
in 14% of cases compared to 3% risk of additional drainage
with arthrotomy [66]. There were worse clinical outcomes and
increased radiological findings at follow-up after arthrotomy
289
than with arthroscopy; however, the authors felt it was dif-
ficult to draw conclusions as the quality of studies was low
[66]. From the available literature, it appears arthroscopy with
the use of a drain is an effective technique for treating pedi-
atric septic hip arthritis, including very young children from
6 months of age [67].
Sequelae of Slipped Capital Femoral Epiphyses
Assessment and Diagnosis
Slipped capital femoral epiphyses (SCFE) is the most com-
mon adolescent hip pathology, with an incidence of up to
10 cases per 100,000 [68]. Patients present with either hip/
groin or knee pain and may be unable to weight bear on the
affected leg. On physical exam, the leg may be shortened
and held in an externally rotated position and there is limited
internal rotation, abduction, and flexion of the affected hip
[69]. Anteroposterior and frog leg lateral radiographs dis-
play the posterior-inferior translation of the capital femoral
epiphysis in relation to the metaphysis [69]. Treatment of
SCFE is initially with either in situ pinning or open reduc-
tion. Even in cases with mild residual deformity, there is an
increased risk of osteoarthritis after SCFE treatment [70].
Indications and Treatment
Persistent deformity at the proximal femoral epiphysis leads to
FAI secondary to SCFE [71, 72]. The resulting deformity results
in loss of sphericity at the anterior femoral neck and results in
an increased alpha angle [71]. Arthroscopy post-SCFE fixation
has shown chondrolabral pathology, impingement at the anterior
acetabular rim, and labral tears, with more advanced pathology
the longer out from SCFE fixation [72, 74]. At 5-year follow-
up, a retrospective review of SCFE patients treated with in situ
pinning and staged arthroscopy showed stable improvement in
the alpha angle to within normal range and normal hip internal
range of motion [73•]. There were signs of progressive cartilage
damage in 4/11 patients at 5-year follow-up MRI [73•]. A system-
atic review by Saito et al. found that in FAI secondary to SCFE,
arthroscopic osteochondroplasty improved PROMs at short-term
follow-up, improved hip internal rotation, and restored the alpha
angle [74]. In patients with severe slips (> 60 degrees), more
complex deformities such as acetabular or femoral retroversion
can develop, which are challenging to address with arthroscopy
[75]. While there is evidence that FAI after severe SCFE may be
treated successfully with arthroscopy, other research has shown
poor results in those with severe SCFE [76, 77]. Arthroscopy to
address post-SCFE FAI has good results in mild and moderate
slips, while further research is needed to determine outcomes in
more severe slips. A short interval between initial SCFE manage-
ment and arthroscopy may reduce the long-term sequelae associ-
ated with post-SCFE FAI [74].
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Conclusion
Hip arthroscopy is used in pediatric and adolescent patients
for a variety of indications including FAI, LCPD, SCFE,
septic hip arthritis, and developmental hip dysplasia. Safety
of hip arthroscopy in very young children to adolescents has
been demonstrated, with some evidence for shorter duration
of hospitalization and operative times over open procedures
[65••, 84]. Short- to medium-term outcomes show signifi-
cant improvements in patient-reported outcome measures
and return to sport [26, 27, 36, 39•, 44, 45, 62••, 65••, 73•,
74]. Studies reporting long-term follow-up will further help
to refine indications for hip arthroscopy in adolescents.
Data Availability No datasets were generated or analysed during the
current study.
Declarations
Ethics Approval All reported studies/experiments with human or animal
subjects performed by the authors have been previously published and
complied with all applicable ethical standards (including the Helsinki
declaration and its amendments, institutional/national research com-
mittee standards, and international/national/institutional guidelines).
Conflict of Interest Helen Crofts, Mark McConkey, and Parth Lodhia
declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent This article does not
contain any studies with human or animal subjects performed by any
of the authors.
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