Introduction: The management of a hip destroyed by infection during growth is difficult and controversial. Two clinical cases illustrate differing management options and question what might be the best solution for this problem.

Case 1: A 12-year-old girl presented with a Staphylococcus aureus septic arthritis of the left hip. She underwent an arthrodesis of the hip one-year later because of a poor position of the hip. She had 20mm of shortening of the left lower limb. After 6 years of “normal” life she received a total hip replacement when aged 19 years. Since then she has no pain and has 12 mm of shortening of her left lower limb and a mobile left hip (100/0, 40/30, 30/30) and works as a cashier.

Case 2 A 2-year-old boy presented with a Salmonella septicaemia and septic arthritis of the right hip. The hip deteriorated but the parents refused a hip arthrodesis. He underwent a Colonna procedure in 1994. Five years later he had developed 50mm of shortening in the right lower limb and he had an epiphysiodesis of the left knee. He is now 17 years old, has a painless hip, satisfactory range of movement (90/0, 0/15, 5/5), a slight limp, equal leg length and enjoys normal teenager activities. Radiographs suggest that he would benefit from a hip replacement.