Arthroscopy of the native hip is an established diagnostic and therapeutic procedure. Its application in the symptomatic replaced hip is still being explored. We describe the use of arthroscopy of the hip in 24 symptomatic patients following total hip replacement, resurfacing arthroplasty of the hip and partial resurfacing (study group), and compared it with arthroscopy of the native hip in 24 patients (control group). A diagnosis was made or confirmed at arthroscopy in 23 of the study group and a therapeutic arthroscopic intervention resulted in relief of symptoms in ten of these. In a further seven patients it led to revision hip replacement. In contrast, arthroscopy in the control group was diagnostic in all 24 patients and the resulting arthroscopic therapeutic intervention provided symptomatic relief in 21.

The mean operative time in the study group (59.7 minutes (35 to 93)) was less than in the control group (71 minutes (40 to 100), p = 0.04) but the arthroscopic approach was more difficult in the arthroplasty group. We suggest that arthroscopy has a role in the management of patients with a symptomatic arthroplasty when other investigations have failed to provide a diagnosis.

Background: Aim of the study was to evaluate the clinical results of Montgomery Hip Screw for fixation of proximal femoral osteotomies. There are a number of devices for proximal femoral fixation, including sliding hip screws. Rotational instability of the proximal femoral segment can be a problem. To overcome this, a hip screw has been introduced with two screws in the proximal segment.

Methods and Results: A prospective cohort undergoing osteotomy was followed up. Inclusion criteria included consecutive patients < 16 years of age, with an indication for elective proximal femoral osteotomy. All operations were performed by senior author or under his supervision using a standard postero-lateral approach. Further incisions for adductor/psoas release and pelvic osteotomy were added as indicated. In 23 cases MHS was used with a mean follow up of 10 months (6 to 24). In 9 patients there was an underlying neurological problem, one case of LCPD, and the rest had DDH. Previous surgery with a hip screw on the contralateral side had been undertaken in 5 cases. The mean age was 5 years (range 1 to 12) and mean time to union was 6.3 weeks. There were no occurrences of rotational instability or failure of fixation. No wound complication was encountered in the cohort.

Conclusions: Early results indicate that Montgomery Hip Screw is a safe device for fixation of proximal femoral osteotomy with the added advantage of rotational stability.