Arthroscopic mobilization of the hip joint in children with aseptic necrosis of the femur head.

The purpose of the study was to evaluate the ability of arthroscopic mobilization of the hip to improve restricted range of motion after failed conservative therapy (level IV) of patient with aseptic necrosis of the femoral head. We examined 11 patients (eight male, three female). The average age at follow-up was 13 years (8-17 years). All 11 patients suffered from idiopathic femur head necrosis (M. Perthes). A minimum 1-year follow-up revealed an average increase of hip motion of 20 degrees of flexion, 15 degrees of abduction (P=0.007), 30 degrees of adduction (P=0.03), 15 degrees of external rotation, and 20 degrees of internal rotation. Arthroscopic hydraulic hip distension with postoperative physiotherapy in a brace under epidural anesthesia of the hip joint leads to an increased range of motion of the affected hip and allows additional intraarticular assessment of the joint. Whether the arthroscopic findings will alter the treatment and prognosis of future patients has to be established with further studies.