Dysplasia of the hip can alter hip biomechanics resulting in higher contact stresses in the joint, which can lead to degenerative changes in affected adolescents. Hip dysplasia can lead to intra-articular pathology including cartilage degeneration and labral tears, resulting in debilitating pain and dysfunction in these patients. Arthroscopic treatment can be used as an adjunct to open procedures for symptomatic treatment of intra-articular pathology. Needle arthroscopy describes a minimally-invasive form of arthroscopy whereby a narrow diameter arthroscope and small-bore instruments are introduced percutaneously. One such device, the Arthrex NanoScope, consists of a 1.9mm diameter needle arthroscope inserted through a 2.4mm cannula. We describe the use of the Arthrex NanoScope in the treatment of a 12-year-old female that presented with hip osteoarthritis secondary to a previously operated developmental hip dysplasia. A two-portal technique was utilised using anterolateral and anterior hip portals. Performing percutaneous needle arthroscopy facilitated a well targeted intra-articular hip injection and reduced the radiation exposure associated with conventional hip arthrography. Needle arthroscopy allowed for direct visualisation of the joint condition which helped with planning of subsequent reconstructive surgery. Post-operative hip examination demonstrated marked improvements in range of motion and the patient reported a significant improvement in pain. The patient was discharged on the same day and there were no complications. We conclude that needle arthroscopy may be used safely and effectively in the setting of hip dysplasia in adolescence.

Introduction- Open reduction for developmental dysplasia of hip (DDH) is a commonly performed procedure which is associated with anxiety amongst parents. Enhanced recovery after surgery (ERAS) pathway consists of a set of interventions meant to improve the peri-operative experience. We applied ERAS protocols to the care of children with DDH to reduce the associated anxiety and improve outcomes.

Methods- A prospective double-blinded RCT was conducted including 44 patients undergoing unilateral open reduction; with 22 patients in each arm (ERAS and Conventional care). Parents in the ERAS pathway were counselled pre-operatively ,taught spica care with a spica doll. The children were also kept fasting for shorter periods and given non-opioid analgesia. They were mobilized early post-operatively on a spica stroller. The primary outcome was postoperative FLACC score, pre-operative parental anxiety was assessed using the STAI scale and parental satisfaction was assessed at 3 months using the Swedish parental satisfaction questionnaire.
Results- Mean age was 2.76 ± 1.32 years (34 females, 10 males). Baseline characteristics of the groups were similar. Post-operative FLACC scores and episodes of vomiting were significantly lesser for the ERAS group. The length of hospital stay was significantly shorter for the ERAS group . The mean pre-operative STAI anxiety score was significantly higher in the conventional pathway than the ERAS group (p<0.001). Parental satisfaction was significantly greater in the ERAS group.

Conclusion- ERAS care is effective in reducing postoperative pain in children with DDH undergoing open reduction. It also reduces parental anxiety and increases parental satisfaction.

INTRODUCTION
The Joint Commision of Taiwan launched the infant hip dysplascia disease specific care certification program. Changhua Christian Children's Hospital is the first certified healthcare organization in this program. This program aims to encourage comprehensive infant hip care services from hip dysplascia prevention to acute and chronic hip dysplascia care to meet neonate hip healthcare demands. The efficiency of the early diagnosis and avoidance of the major surgery in DDH was imrpoved.
MATERIALS & METHOD
We set up a cross-disciplinary team integrating in the infant hip dysplascia care. This progam was launched from March 2022. The hip stability was assessed with standard hip physical examination, followed by selective hip ultrasound according to the risk factor and each hip stability. Either observation, Pavlik harness treatment, or close reduction were applied according to each hip condition. The DDH prevention baby care method was introduced to the parents. The incidence of early diagnosis, surgery were collected.
RESULTS / DISCUSSION
The total number of hip screen was 2494. 258 cases were classified as hip dysplascia. The early detection rate was 5.82%. No case failed Pavlik harness treatment. The incidence of DDH surgery was 0.00%. In our study, the incidence of early diagnosis was higher than the average incidence of DDH in Taiwanese population. The incidence of surgery is lower than the average incidence of surgery in Taiwanese population.
CONCLUSION
The infant hip dysplascia DSC certification program improved the efficiency of the early diagnosis and treatment of DDH and avoid major surgery in the infants.

Introduction: in practice, there is often a need for diagnosis and differential diagnosis of diseases of the femoral head in preschool children. To date, isolated dysplasia of the femoral heads - Meyer's dysplasia - has not been sufficiently studied.
Purpose: To study the semiotics of changes in the hip joint in patients with Meyer's dysplasia for differential diagnosis. Materials and methods: prospective cohort study. X-ray data, MSCT (multi-slice computed tomography), MRI before treatment were studied in 20 patients with Meyer's dysplasia. Results: patient age ranged from 1 to 3 years. There were 13 boys, 7 girls. Bilateral lesions were diagnosed in 9, unilateral in 11 patients. Coverage of the femoral head was complete in all. The epiphysis index averaged 2. According to X-ray and computed tomography data, fragmentation of the ossification nucleus was visualized. According to MRI, the integrity of the articular cartilage was preserved, the height was uniform, and in 5 patients an increase in the amount of fluid in the joint cavity was detected. In comparison with Legg-Calvé-Perthes disease, there were no foci of necrosis, bone marrow edema, or deformation of the head. Conclusion: thus, a thorough examination of patients with suspected pathology of the hip joint allows us to avoid unjustified prescription of treatment for these patients.