Abstract
The childhood hip conditions of Developmental Dysplasia, Legg-Calve-Perthes Disease and Slipped Capital Femoral Epiphysis have a wide spectrum of anatomical outcomes following childhood treatment; ranging from morphologies, which result in normal hip function throughout life, to severely deranged morphologies, which result in pain and disability during childhood and adolescence. Some of these outcomes are as a result of well-intentioned interventions that result in catastrophic complications.
In 2003, after years of working with impingement complicating periacetabular osteotomies and building on the work of William Harris, Reinhold Ganz published his concepts of ‘cam’ and ‘pincer’ hip impingement, and how these anatomical morphologies resulted in hip arthritis in adulthood. These concepts of impingement were added to his previous published work on hip instability to provide a comprehensive theory describing how hip arthritis develops on the basis of anatomical abnormalities. Surgical techniques have been developed to address each of these morphological pathologies.
Ganz's concepts of hip impingement and instability may be applied to severe paediatric hip deformities to direct reconstructive joint preserving surgery to both the femur and the acetabulum. Ganz's surgical approaches have also been refined for use in paediatric hip surgery to allow radical reshaping salvage osteotomies to be performed on the developing femoral head with minimal risk of the devastating consequence of vascular Necrosis.
