Unusual osteocartilaginous prominence or bump causing femoroacetabular impingement after septic arthritis of the hip: a report of 2 cases in preadolescence.
BACKGROUND
Few data are available concerning the indications, outcomes, or optimum timing of femoral osteochondroplasty in patients with late sequelae of septic arthritis of the hip.


METHODS
This paper presents 2 unusual cases of Choi type II sequelae associated with a large osteocartilaginous prominence or bump of the femoral head, responsible for cam-type femoroacetabular impingement in preadolescence.


RESULTS
Two active preadolescents presented with groin pain after activity, a slightly antalgic gait, and difficulty squatting fully. On physical examination, both had less than 20 degrees of internal rotation with the hip in 90 degrees of flexion and a positive impingement sign, whereby groin pain was provoked by hip flexion, adduction, and internal rotation. One patient underwent osteochondroplasty and femoral valgus osteotomy, and the other osteochondroplasty alone, through surgical dislocation. Postoperatively, both had markedly improved free hip motion and no impingement sign.


CONCLUSIONS
Patients with type II sequelae before reaching skeletal maturity may present with femoroacetabular impingement symptoms. These 2 cases show that impingement-free hip motion through surgical dislocation improves symptoms.
Shin
Sung Jin
SJ
Department of Orthopaedic Surgery, Seoul National University Children's Hospital, Seoul, Korea.
Choi
In Ho
IH
Cho
Tae-Joon
TJ
Yoo
Won Joon
WJ
Chung
Chin Youb
CY
Park
Moon Seok
MS
D000077:Acetabulum / Q000473:pathology / Q000601:surgery; D000365:Age Determination by Skeleton; D001170:Arthritis, Infectious / Q000503:physiopathology / Q000601:surgery*; D002358:Cartilage, Articular / Q000473:pathology / Q000601:surgery; D002648:Child; D005260:Female; D005270:Femur Head / Q000473:pathology / Q000601:surgery*; D006621:Hip Joint / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D010027:Osteotomy / Q000379:methods; D010146:Pain / Q000209:etiology; D016059:Range of Motion, Articular